Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $548.22 / $5,165.00 / $17,380.00	Facility		$548.22	$5,165.00	$17,380.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.64 / $400.49 / $1,235.69	Professional		$199.64	$400.49	$1,235.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $873.00 / $4,417.00 / $9,244.00	Facility		$873.00	$4,417.00	$9,244.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.00 / $520.80 / $964.74	Professional		$261.00	$520.80	$964.74
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $4,886.39	Facility		$67.90	$100.00	$4,886.39
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $233.75 / $451.32 / $890.82	Professional		$233.75	$451.32	$890.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.09 / $730.77 / $1,721.63	Facility		$354.09	$730.77	$1,721.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.43 / $439.28 / $838.68	Professional		$223.43	$439.28	$838.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $175.73 / $265.92 / $670.14	Professional		$175.73	$265.92	$670.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.00 / $408.86 / $744.60	Professional		$208.00	$408.86	$744.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,183.84 / $1,211.80 / $12,000.00	Facility		$1,183.84	$1,211.80	$12,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,812.00 / $2,887.76 / $3,361.50	Professional		$1,812.00	$2,887.76	$3,361.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $337.88	Professional		$32.34	$32.34	$337.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $229.60 / $416.19 / $712.16	Facility		$229.60	$416.19	$712.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $230.82 / $481.28 / $990.77	Professional		$230.82	$481.28	$990.77
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $688.72 / $688.72 / $1,307.83	Professional		$688.72	$688.72	$1,307.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $186.95 / $257.06 / $551.66	Professional		$186.95	$257.06	$551.66
United Facility/Professional Facility Modifier Low / Median / High Price $833.75 / $3,928.00 / $9,131.00	Facility		$833.75	$3,928.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $323.94 / $463.96 / $992.21	Professional		$323.94	$463.96	$992.21