Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $4,265.80	Facility		$1,513.56	$1,513.56	$4,265.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,290.87 / $2,818.38	Professional		$1,513.56	$2,290.87	$2,818.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $15,135.61 / $15,135.61	Facility		$7,585.78	$15,135.61	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,995.26 / $3,630.78	Professional		$1,445.44	$1,995.26	$3,630.78
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $6,760.83 / $8,511.38	Facility		$2,187.76	$6,760.83	$8,511.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,290.87 / $5,888.44	Professional		$1,737.80	$2,290.87	$5,888.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $5,011.87 / $10,000.00	Facility		$1,995.26	$5,011.87	$10,000.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,019.95 / $4,073.80	Professional		$2,398.83	$3,019.95	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,311.31 / $5,248.07	Professional		$2,691.53	$3,311.31	$5,248.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $14,125.38 / $14,125.38 / $14,125.38	Facility		$14,125.38	$14,125.38	$14,125.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $15,135.61 / $22,387.21 / $22,387.21	Professional		$15,135.61	$22,387.21	$22,387.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,630.78 / $7,762.47	Facility		$2,041.74	$3,630.78	$7,762.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,311.31 / $4,365.16	Professional		$3,019.95	$3,311.31	$4,365.16
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional		$3,019.95	$3,019.95	$3,019.95
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,019.95 / $36,307.81	Professional		$2,398.83	$3,019.95	$36,307.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,019.95 / $3,019.95	Facility		$1,258.93	$3,019.95	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $5,754.40	Professional		$1,258.93	$1,258.93	$5,754.40