Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.30 / $92.56 / $644.26	Facility		$69.30	$92.56	$644.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $89.54 / $404.43	Professional		$65.62	$89.54	$404.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,464.00 / $8,976.00	Facility		$1,723.00	$4,464.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.90 / $104.41 / $210.42	Professional		$75.90	$104.41	$210.42
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $74.72 / $101.27 / $208.45	Professional		$74.72	$101.27	$208.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $113.71 / $203.65	Facility		$56.00	$113.71	$203.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $111.66 / $215.71	Professional		$78.84	$111.66	$215.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $85.24 / $143.11	Professional		$62.17	$85.24	$143.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.18 / $117.18 / $212.82	Professional		$77.18	$117.18	$212.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $351.19 / $376.82	Facility		$55.00	$351.19	$376.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $550.72 / $784.48 / $932.33	Professional		$550.72	$784.48	$932.33
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 $75.77 / $111.33 / $167.56	Facility		$75.77	$111.33	$167.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.75 / $117.05 / $249.73	Professional		$79.75	$117.05	$249.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $250.92 / $250.92 / $347.09	Professional		$250.92	$250.92	$347.09
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $68.66 / $94.41 / $144.44	Professional		$68.66	$94.41	$144.44
United Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,506.00 / $6,920.00	Facility		$545.00	$1,506.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $104.74 / $230.42	Professional		$79.56	$104.74	$230.42