Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $915.09 / $924.24	Facility		$915.09	$915.09	$924.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,006.60	Professional		$915.09	$915.09	$1,006.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $629.95 / $757.35 / $1,281.36	Facility		$629.95	$757.35	$1,281.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $652.66 / $888.48 / $1,638.17	Professional		$652.66	$888.48	$1,638.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $732.07	Professional		$100.00	$100.00	$732.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $863.29 / $863.29 / $915.09	Facility		$863.29	$863.29	$915.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $992.78	Professional		$915.09	$915.09	$992.78
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $487.72 / $536.49 / $658.42	Professional		$487.72	$536.49	$658.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $823.58 / $1,143.85 / $1,994.90	Professional		$823.58	$1,143.85	$1,994.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $2,153.31 / $2,153.31	Facility		$1,417.80	$2,153.31	$2,153.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,296.35 / $3,021.52 / $3,610.00	Professional		$2,296.35	$3,021.52	$3,610.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $536.49 / $999.82 / $999.82	Professional		$536.49	$999.82	$999.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $915.09 / $924.24 / $1,558.39	Facility		$915.09	$924.24	$1,558.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $702.35 / $915.09 / $1,165.44	Professional		$702.35	$915.09	$1,165.44
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $487.72 / $585.26 / $1,006.60	Professional		$487.72	$585.26	$1,006.60
United Facility/Professional Professional Modifier Low / Median / High Price $915.09 / $915.09 / $1,737.57	Professional		$915.09	$915.09	$1,737.57