Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,625.00 / $8,413.29 / $25,138.80	Facility		$2,625.00	$8,413.29	$25,138.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,275.00 / $2,975.00 / $3,290.00	Professional		$2,275.00	$2,975.00	$3,290.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $6,760.95 / $17,426.50	Facility		$614.00	$6,760.95	$17,426.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.16 / $3,991.26 / $8,030.79	Professional		$239.16	$3,991.26	$8,030.79
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $4,620.00 / $31,395.00	Facility		$59.40	$4,620.00	$31,395.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $2,450.00 / $3,500.00 / $8,798.65	Professional		$2,450.00	$3,500.00	$8,798.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,379.10 / $5,869.50 / $11,716.25	Facility		$2,379.10	$5,869.50	$11,716.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,380.00 / $2,380.00 / $2,380.00	Professional		$2,380.00	$2,380.00	$2,380.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,800.00 / $3,500.00 / $4,725.00	Professional		$2,800.00	$3,500.00	$4,725.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,150.00 / $4,025.00 / $7,630.00	Professional		$3,150.00	$4,025.00	$7,630.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,090.00 / $16,625.00 / $16,625.00	Facility		$6,090.00	$16,625.00	$16,625.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $17,500.00 / $17,500.00 / $26,250.00	Professional		$17,500.00	$17,500.00	$26,250.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,414.79 / $5,027.75 / $10,601.50	Facility		$2,414.79	$5,027.75	$10,601.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,500.00 / $3,850.00 / $6,125.00	Professional		$3,500.00	$3,850.00	$6,125.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,500.00 / $3,500.00 / $3,500.00	Professional		$3,500.00	$3,500.00	$3,500.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,800.00 / $3,150.00 / $4,760.00	Professional		$2,800.00	$3,150.00	$4,760.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,470.00 / $1,484.00 / $7,760.90	Professional		$1,470.00	$1,484.00	$7,760.90