Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $10,000.00 / $21,379.62	Facility		$4,073.80	$10,000.00	$21,379.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,621.81 / $7,585.78	Professional		$1,174.90	$1,621.81	$7,585.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $11,481.54 / $17,782.79	Facility		$6,456.54	$11,481.54	$17,782.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,137.96 / $5,128.61	Professional		$1,412.54	$2,137.96	$5,128.61
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $5,495.41 / $13,182.57	Facility		$66.07	$5,495.41	$13,182.57
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,905.46 / $3,890.45	Professional		$1,318.26	$1,905.46	$3,890.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $4,365.16	Facility		$3,715.35	$3,715.35	$4,365.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,584.89 / $3,467.37	Professional		$1,071.52	$1,584.89	$3,467.37
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,122.02 / $2,089.30	Professional		$741.31	$1,122.02	$2,089.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,698.24 / $2,818.38	Professional		$1,288.25	$1,698.24	$2,818.38
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $16,595.87 / $42,657.95 / $42,657.95	Facility		$16,595.87	$42,657.95	$42,657.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,549.93 / $11,220.18 / $11,220.18	Professional		$9,549.93	$11,220.18	$11,220.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Professional		$1,905.46	$1,905.46	$1,905.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,698.24 / $2,691.53	Facility		$1,148.15	$1,698.24	$2,691.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,584.89 / $3,467.37	Professional		$1,047.13	$1,584.89	$3,467.37
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Professional		$4,365.16	$4,365.16	$4,365.16
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,318.26 / $1,659.59	Professional		$933.25	$1,318.26	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $12,302.69 / $25,703.96	Facility		$6,760.83	$12,302.69	$25,703.96
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,445.44 / $3,890.45	Professional		$977.24	$1,445.44	$3,890.45