Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $713.50 / $713.50 / $720.64	Facility		$713.50	$713.50	$720.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $784.85	Professional		$713.50	$713.50	$784.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $908.70 / $1,092.47 / $1,848.37	Facility		$908.70	$1,092.47	$1,848.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $994.75 / $2,653.40	Professional		$713.50	$994.75	$2,653.40
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 / $1,387.50	Professional		$100.00	$100.00	$1,387.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $673.11 / $673.11 / $713.50	Facility		$673.11	$673.11	$713.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $875.05	Professional		$713.50	$713.50	$875.05
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,280.74 / $1,408.81 / $1,728.99	Professional		$1,280.74	$1,408.81	$1,728.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $642.15 / $891.88 / $1,616.93	Professional		$642.15	$891.88	$1,616.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,351.50 / $1,812.38 / $5,654.61	Facility		$1,351.50	$1,812.38	$5,654.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,654.61 / $5,654.61 / $5,654.61	Professional		$5,654.61	$5,654.61	$5,654.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,408.81 / $1,728.99 / $2,625.51	Professional		$1,408.81	$1,728.99	$2,625.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $713.50 / $784.85 / $1,279.95	Facility		$713.50	$784.85	$1,279.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $1,590.00	Professional		$713.50	$713.50	$1,590.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $570.79 / $1,280.74 / $1,536.89	Professional		$570.79	$1,280.74	$1,536.89
United Facility/Professional Professional Modifier Low / Median / High Price $713.50 / $713.50 / $1,519.61	Professional		$713.50	$713.50	$1,519.61