Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,630.27 / $4,365.16	Facility		$891.25	$2,630.27	$4,365.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $524.81 / $645.65	Professional		$426.58	$524.81	$645.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $3,235.94 / $3,235.94	Facility		$1,621.81	$3,235.94	$3,235.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $575.44	Professional		$208.93	$208.93	$575.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,380.38 / $1,819.70	Facility		$100.00	$1,380.38	$1,819.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $1,174.90	Professional		$371.54	$478.63	$1,174.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $831.76 / $2,089.30	Facility		$426.58	$831.76	$2,089.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $707.95 / $891.25	Professional		$457.09	$707.95	$891.25
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $645.65 / $1,023.29	Professional		$100.00	$645.65	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $645.65 / $1,122.02	Professional		$512.86	$645.65	$1,122.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility		$3,019.95	$3,019.95	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $691.83 / $1,513.56	Facility		$426.58	$691.83	$1,513.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $645.65 / $645.65	Professional		$457.09	$645.65	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $354.81 / $645.65	Facility		$269.15	$354.81	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $1,148.15	Professional		$269.15	$288.40	$1,148.15