Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,290.17 / $6,516.00 / $17,133.00	Facility		$1,290.17	$6,516.00	$17,133.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $562.86 / $645.09 / $3,819.46	Facility	52	$562.86	$645.09	$3,819.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,062.39 / $1,287.89 / $3,586.67	Professional		$1,062.39	$1,287.89	$3,586.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,696.00 / $7,166.00 / $15,328.00	Facility		$2,696.00	$7,166.00	$15,328.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,070.36 / $1,399.45 / $2,770.65	Professional		$1,070.36	$1,399.45	$2,770.65
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,011.98	Facility		$66.00	$100.00	$8,011.98
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $996.91 / $1,424.15 / $3,079.99	Professional		$996.91	$1,424.15	$3,079.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,183.41 / $1,513.92 / $3,112.51	Professional		$1,183.41	$1,513.92	$3,112.51
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $940.80 / $1,430.85 / $1,779.65	Professional		$940.80	$1,430.85	$1,779.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,151.91 / $1,582.97 / $2,980.52	Professional		$1,151.91	$1,582.97	$2,980.52
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,859.30 / $11,500.00 / $26,542.00	Facility		$5,859.30	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,274.26 / $8,418.48 / $8,418.48	Facility	52	$2,274.26	$8,418.48	$8,418.48
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $284.27 / $1,052.31 / $1,052.31	Facility	AS	$284.27	$1,052.31	$1,052.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,066.48 / $9,294.87 / $10,750.35	Professional		$9,066.48	$9,294.87	$10,750.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,168.45 / $1,557.69 / $2,060.23	Facility		$1,168.45	$1,557.69	$2,060.23
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $484.24 / $484.24 / $484.24	Facility	80	$484.24	$484.24	$484.24
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $411.61 / $411.61 / $411.61	Facility	AS	$411.61	$411.61	$411.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,196.73 / $1,549.88 / $3,112.51	Professional		$1,196.73	$1,549.88	$3,112.51
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,208.62 / $4,208.62 / $4,208.62	Professional		$4,208.62	$4,208.62	$4,208.62
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,154.61 / $1,542.35 / $2,016.93	Professional		$1,154.61	$1,542.35	$2,016.93
United Facility/Professional Facility Modifier Low / Median / High Price $5,116.00 / $9,758.00 / $21,278.00	Facility		$5,116.00	$9,758.00	$21,278.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,040.14 / $1,353.11 / $2,866.26	Professional		$1,040.14	$1,353.11	$2,866.26