Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,932.00 / $16,713.00	Facility		$344.00	$4,932.00	$16,713.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $128.68 / $458.41	Professional		$79.48	$128.68	$458.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,456.00	Facility		$2,137.00	$5,863.00	$11,456.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.58 / $200.34 / $403.10	Professional		$116.58	$200.34	$403.10
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $100.00 / $11,616.47	Facility		$64.00	$100.00	$11,616.47
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $146.79 / $276.36	Professional		$89.31	$146.79	$276.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.48 / $150.11 / $308.69	Professional		$90.48	$150.11	$308.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $88.77 / $123.98 / $189.70	Professional		$88.77	$123.98	$189.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $138.65 / $237.02	Professional		$85.27	$138.65	$237.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $395.09 / $407.74	Facility		$55.00	$395.09	$407.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $613.91 / $741.75 / $1,168.88	Professional		$613.91	$741.75	$1,168.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.80 / $141.69 / $215.15	Facility		$93.80	$141.69	$215.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.59 / $163.13 / $340.23	Professional		$91.59	$163.13	$340.23
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $284.43 / $284.43 / $505.62	Professional		$284.43	$284.43	$505.62
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $80.44 / $127.58 / $185.96	Professional		$80.44	$127.58	$185.96
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $6,920.00	Facility		$548.00	$1,533.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.48 / $178.00 / $452.19	Professional		$126.48	$178.00	$452.19