Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,945.55 / $3,945.55 / $100,277.00	Facility		$3,945.55	$3,945.55	$100,277.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,730.80 / $3,945.55 / $100,277.00	Professional		$2,730.80	$3,945.55	$100,277.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,751.00 / $10,099.00 / $20,369.00	Facility		$3,751.00	$10,099.00	$20,369.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,036.98 / $20,374.38 / $48,249.51	Professional		$1,036.98	$20,374.38	$48,249.51
Anthem BCBS Facility/Professional Professional Modifier 80 Low / Median / High Price $147.80 / $2,280.34 / $2,447.88	Professional	80	$147.80	$2,280.34	$2,447.88
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $129.33 / $1,995.30 / $2,141.89	Professional	AS	$129.33	$1,995.30	$2,141.89
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $4,062.37 / $7,921.48 / $24,422.74	Facility		$4,062.37	$7,921.48	$24,422.74
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $822.24 / $8,918.99 / $36,675.58	Professional		$822.24	$8,918.99	$36,675.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,065.96 / $1,537.36 / $25,911.28	Professional		$1,065.96	$1,537.36	$25,911.28
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $632.91 / $850.94 / $17,581.24	Professional		$632.91	$850.94	$17,581.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $681.32 / $7,132.50 / $18,291.68	Professional		$681.32	$7,132.50	$18,291.68
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,606.30 / $17,551.46	Facility		$55.00	$5,606.30	$17,551.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $42,239.10 / $76,528.09 / $88,256.40	Professional		$42,239.10	$76,528.09	$88,256.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $778.40 / $1,709.01 / $20,402.25	Facility		$778.40	$1,709.01	$20,402.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $681.32 / $2,054.51 / $31,779.05	Professional		$681.32	$2,054.51	$31,779.05
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $5,084.64 / $6,428.29 / $403,200.00	Professional	80	$5,084.64	$6,428.29	$403,200.00
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $4,321.95 / $5,464.05 / $342,720.00	Professional	AS	$4,321.95	$5,464.05	$342,720.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,296.19 / $2,296.19 / $49,362.84	Professional		$2,296.19	$2,296.19	$49,362.84
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $632.91 / $822.78 / $15,648.71	Professional		$632.91	$822.78	$15,648.71
United Facility/Professional Facility Modifier Low / Median / High Price $23,417.88 / $29,602.64 / $45,511.54	Facility		$23,417.88	$29,602.64	$45,511.54
United Facility/Professional Professional Modifier Low / Median / High Price $11,876.21 / $17,676.64 / $41,641.62	Professional		$11,876.21	$17,676.64	$41,641.62