Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $358.75 / $358.75 / $358.75	Facility		$358.75	$358.75	$358.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $358.75 / $358.75 / $1,657.50	Professional		$358.75	$358.75	$1,657.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.00 / $614.00 / $9,769.50	Facility		$244.00	$614.00	$9,769.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.16 / $344.39 / $4,660.50	Professional		$239.16	$344.39	$4,660.50
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $1,409.85 / $5,499.00	Facility		$92.60	$1,409.85	$5,499.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $887.25 / $1,267.50 / $3,186.37	Professional		$887.25	$1,267.50	$3,186.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.81 / $2,801.18 / $6,527.63	Facility		$59.81	$2,801.18	$6,527.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,950.00 / $1,950.00 / $1,950.00	Professional		$1,950.00	$1,950.00	$1,950.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,560.00 / $1,950.00 / $2,632.50	Professional		$1,560.00	$1,950.00	$2,632.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,755.00 / $2,242.50 / $3,724.50	Professional		$1,755.00	$2,242.50	$3,724.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,393.00 / $9,262.50 / $9,262.50	Facility		$3,393.00	$9,262.50	$9,262.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,711.00 / $9,711.00 / $14,625.00	Professional		$9,711.00	$9,711.00	$14,625.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $513.01 / $2,340.00 / $5,108.99	Facility		$513.01	$2,340.00	$5,108.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,950.00 / $2,145.00 / $2,925.00	Professional		$1,950.00	$2,145.00	$2,925.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,950.00 / $1,950.00 / $1,950.00	Professional		$1,950.00	$1,950.00	$1,950.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,560.00 / $1,755.00 / $2,652.00	Professional		$1,560.00	$1,755.00	$2,652.00
United Facility/Professional Professional Modifier Low / Median / High Price $819.00 / $819.00 / $3,874.26	Professional		$819.00	$819.00	$3,874.26