Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.56 / $11,790.00 / $25,694.00	Facility		$1,621.56	$11,790.00	$25,694.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.51 / $1,621.56 / $8,382.58	Professional		$1,380.51	$1,621.56	$8,382.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,917.00 / $9,106.31 / $19,298.00	Facility		$3,917.00	$9,106.31	$19,298.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,619.72 / $2,089.10 / $4,081.70	Professional		$1,619.72	$2,089.10	$4,081.70
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $7,344.10	Facility		$63.90	$100.00	$7,344.10
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,112.45 / $1,606.23 / $3,728.77	Professional		$1,112.45	$1,606.23	$3,728.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $900.00 / $6,869.00	Facility		$633.00	$900.00	$6,869.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,448.04 / $2,012.88 / $4,316.74	Professional		$1,448.04	$2,012.88	$4,316.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,043.56 / $1,774.72 / $2,395.87	Professional		$1,043.56	$1,774.72	$2,395.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,539.95 / $1,976.41 / $3,688.81	Professional		$1,539.95	$1,976.41	$3,688.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $22,333.44 / $22,850.64	Facility		$55.00	$22,333.44	$22,850.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $13,253.41 / $13,469.28 / $14,259.23	Professional		$13,253.41	$13,469.28	$14,259.23
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 $1,572.05 / $2,029.06 / $3,012.40	Facility		$1,572.05	$2,029.06	$3,012.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,476.87 / $2,119.21 / $4,373.38	Professional		$1,476.87	$2,119.21	$4,373.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $5,201.24 / $5,201.24 / $5,201.24	Professional		$5,201.24	$5,201.24	$5,201.24
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,043.56 / $1,608.95 / $1,966.49	Professional		$1,043.56	$1,608.95	$1,966.49
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.00 / $4,820.00 / $20,279.00	Facility		$1,055.00	$4,820.00	$20,279.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,285.72 / $1,753.44 / $3,914.56	Professional		$1,285.72	$1,753.44	$3,914.56