Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,820.00 / $6,631.00 / $17,393.00	Facility		$1,820.00	$6,631.00	$17,393.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.83 / $878.03 / $4,831.75	Professional		$735.83	$878.03	$4,831.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,160.00 / $5,944.00 / $13,697.00	Facility		$2,160.00	$5,944.00	$13,697.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $730.73 / $987.20 / $2,039.48	Professional		$730.73	$987.20	$2,039.48
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,138.75	Facility		$66.00	$100.00	$8,138.75
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $573.41 / $838.84 / $1,995.26	Professional		$573.41	$838.84	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $813.58 / $1,068.04 / $2,485.56	Professional		$813.58	$1,068.04	$2,485.56
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,079.31 / $1,187.24 / $1,457.07	Professional		$1,079.31	$1,187.24	$1,457.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $860.55 / $1,182.68 / $2,482.41	Professional		$860.55	$1,182.68	$2,482.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,460.44 / $10,249.53 / $26,542.00	Facility		$3,460.44	$10,249.53	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,708.00 / $6,791.44 / $7,945.28	Professional		$6,708.00	$6,791.44	$7,945.28
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 $832.54 / $1,150.93 / $1,575.95	Facility		$832.54	$1,150.93	$1,575.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $835.30 / $1,111.94 / $2,436.73	Professional		$835.30	$1,111.94	$2,436.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,998.01 / $2,998.01 / $2,998.01	Professional		$2,998.01	$2,998.01	$2,998.01
United Facility/Professional Facility Modifier Low / Median / High Price $4,035.00 / $7,473.00 / $15,471.00	Facility		$4,035.00	$7,473.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $701.47 / $950.38 / $2,320.33	Professional		$701.47	$950.38	$2,320.33