Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,904.75 / $10,119.50 / $27,817.80	Facility		$2,904.75	$10,119.50	$27,817.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,110.79 / $3,214.59 / $3,292.05	Professional		$2,110.79	$3,214.59	$3,292.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $7,481.47 / $19,283.66	Facility		$614.00	$7,481.47	$19,283.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,246.40 / $4,416.60 / $8,886.62	Professional		$1,246.40	$4,416.60	$8,886.62
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $5,112.35 / $34,740.81	Facility		$59.40	$5,112.35	$34,740.81
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,762.22 / $2,517.44 / $6,328.62	Professional		$1,762.22	$2,517.44	$6,328.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,632.64 / $6,495.02 / $12,964.87	Facility		$2,632.64	$6,495.02	$12,964.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,633.64 / $2,633.64 / $2,633.64	Professional		$2,633.64	$2,633.64	$2,633.64
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3,873.00 / $4,647.60 / $6,196.80	Professional		$3,873.00	$4,647.60	$6,196.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,485.70 / $4,453.95 / $8,443.14	Professional		$3,485.70	$4,453.95	$8,443.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,739.02 / $18,396.75 / $18,396.75	Facility		$6,739.02	$18,396.75	$18,396.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $19,365.00 / $19,365.00 / $29,047.50	Professional		$19,365.00	$19,365.00	$29,047.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,672.13 / $5,563.56 / $11,731.32	Facility		$2,672.13	$5,563.56	$11,731.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,873.00 / $4,260.30 / $5,809.50	Professional		$3,873.00	$4,260.30	$5,809.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,873.00 / $3,873.00 / $3,873.00	Professional		$3,873.00	$3,873.00	$3,873.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,626.66 / $1,692.38 / $9,325.79	Professional		$1,626.66	$1,692.38	$9,325.79