Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,197.85 / $8,183.00 / $20,103.00	Facility		$2,197.85	$8,183.00	$20,103.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,196.13 / $1,432.85 / $7,610.39	Professional		$1,196.13	$1,432.85	$7,610.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,585.00 / $11,216.00 / $21,514.00	Facility		$3,585.00	$11,216.00	$21,514.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,611.21 / $1,998.63 / $3,991.98	Professional		$1,611.21	$1,998.63	$3,991.98
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $5,714.18	Facility		$64.40	$100.00	$5,714.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,082.49 / $1,567.46 / $3,553.51	Professional		$1,082.49	$1,567.46	$3,553.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,277.00 / $2,277.00	Facility		$2,277.00	$2,277.00	$2,277.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,335.30 / $1,785.50 / $3,926.30	Professional		$1,335.30	$1,785.50	$3,926.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,120.61 / $1,651.97 / $2,119.80	Professional		$1,120.61	$1,651.97	$2,119.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,329.84 / $1,841.32 / $3,406.99	Professional		$1,329.84	$1,841.32	$3,406.99
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $12,912.00 / $13,181.68	Facility		$55.00	$12,912.00	$13,181.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $13,577.03 / $13,577.03 / $13,577.03	Professional		$13,577.03	$13,577.03	$13,577.03
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 $1,463.61 / $1,829.48 / $2,734.51	Facility		$1,463.61	$1,829.48	$2,734.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,362.67 / $1,847.47 / $3,807.83	Professional		$1,362.67	$1,847.47	$3,807.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,722.10 / $4,722.10 / $4,722.10	Professional		$4,722.10	$4,722.10	$4,722.10
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,334.67 / $1,680.93 / $2,119.79	Professional		$1,334.67	$1,680.93	$2,119.79
United Facility/Professional Facility Modifier Low / Median / High Price $5,830.00 / $12,341.00 / $26,451.00	Facility		$5,830.00	$12,341.00	$26,451.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,115.61 / $1,437.10 / $3,204.51	Professional		$1,115.61	$1,437.10	$3,204.51