Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,218.72 / $13,267.40 / $25,282.40	Facility		$4,218.72	$13,267.40	$25,282.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,278.56 / $18,230.80 / $20,246.70	Professional		$4,278.56	$18,230.80	$20,246.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $6,799.58 / $17,526.08	Facility		$614.00	$6,799.58	$17,526.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.68 / $1,366.59 / $2,583.67	Professional		$163.68	$1,366.59	$2,583.67
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.90 / $4,808.32 / $31,961.60	Facility		$59.90	$4,808.32	$31,961.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,601.60 / $2,288.00 / $4,347.20	Professional		$1,601.60	$2,288.00	$4,347.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,392.69 / $4,621.76 / $11,348.48	Facility		$2,392.69	$4,621.76	$11,348.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,658.02 / $4,289.83 / $5,362.29	Professional		$1,658.02	$4,289.83	$5,362.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $3,520.00 / $5,632.00	Professional		$99.00	$3,520.00	$5,632.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,816.00 / $3,520.00 / $6,160.00	Professional		$2,816.00	$3,520.00	$6,160.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,632.00 / $16,720.00 / $16,720.00	Facility		$5,632.00	$16,720.00	$16,720.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,550.01 / $4,892.80 / $10,394.37	Facility		$2,550.01	$4,892.80	$10,394.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,640.24 / $3,238.40 / $16,966.40	Professional		$1,640.24	$3,238.40	$16,966.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,520.00 / $3,520.00 / $3,520.00	Professional		$3,520.00	$3,520.00	$3,520.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,478.40 / $1,478.40 / $5,385.60	Professional		$1,478.40	$1,478.40	$5,385.60