Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $7,244.36 / $17,378.01	Facility		$2,630.27	$7,244.36	$17,378.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $7,413.10	Professional		$1,202.26	$1,659.59	$7,413.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $8,128.31 / $15,848.93	Facility		$4,570.88	$8,128.31	$15,848.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,778.28 / $3,890.45	Professional		$1,230.27	$1,778.28	$3,890.45
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $3,162.28 / $9,332.54	Facility		$66.07	$3,162.28	$9,332.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,698.24 / $3,715.35	Professional		$1,202.26	$1,698.24	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,659.59 / $3,090.30	Professional		$1,258.93	$1,659.59	$3,090.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,548.82 / $1,862.09	Professional		$933.25	$1,548.82	$1,862.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,698.24 / $3,548.13	Professional		$1,288.25	$1,698.24	$3,548.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,220.18 / $45,708.82 / $45,708.82	Facility		$11,220.18	$45,708.82	$45,708.82
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $6,918.31 / $6,918.31 / $6,918.31	Facility	62	$6,918.31	$6,918.31	$6,918.31
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility	AS	$1,122.02	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $12,022.64 / $12,882.50 / $12,882.50	Professional		$12,022.64	$12,882.50	$12,882.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Professional		$2,187.76	$2,187.76	$2,187.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,737.80 / $2,454.71	Facility		$1,288.25	$1,737.80	$2,454.71
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility	22	$3,019.95	$3,019.95	$3,019.95
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility	62	$1,584.89	$1,584.89	$1,584.89
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	AS	$257.04	$257.04	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,659.59 / $3,090.30	Professional		$1,258.93	$1,659.59	$3,090.30
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $4,897.79	Professional		$4,897.79	$4,897.79	$4,897.79
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,412.54 / $1,995.26	Professional		$1,174.90	$1,412.54	$1,995.26
United Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $10,000.00 / $21,379.62	Facility		$5,623.41	$10,000.00	$21,379.62
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $2,754.23	Professional		$1,122.02	$1,479.11	$2,754.23