Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.60 / $292.60 / $292.60	Facility		$292.60	$292.60	$292.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.60 / $292.60 / $612.00	Professional		$292.60	$292.60	$612.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.00 / $614.00 / $3,607.20	Facility		$244.00	$614.00	$3,607.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.90 / $297.57 / $1,360.80	Professional		$228.90	$297.57	$1,360.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $520.55 / $2,030.40	Facility		$92.60	$520.55	$2,030.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $327.60 / $468.00 / $1,176.51	Professional		$327.60	$468.00	$1,176.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.15 / $833.04 / $1,820.52	Facility		$482.15	$833.04	$1,820.52
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $576.00 / $720.00 / $972.00	Professional		$576.00	$720.00	$972.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $648.00 / $828.00 / $1,375.20	Professional		$648.00	$828.00	$1,375.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,252.80 / $3,420.00 / $3,420.00	Facility		$1,252.80	$3,420.00	$3,420.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,600.00 / $3,600.00 / $5,400.00	Professional		$3,600.00	$3,600.00	$5,400.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $468.00 / $864.00 / $1,719.44	Facility		$468.00	$864.00	$1,719.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $792.00 / $1,036.80	Professional		$720.00	$792.00	$1,036.80
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $720.00 / $720.00	Professional		$720.00	$720.00	$720.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $576.00 / $648.00 / $979.20	Professional		$576.00	$648.00	$979.20
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $324.00 / $1,425.60	Professional		$302.39	$324.00	$1,425.60