Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,387.00 / $10,289.00 / $22,788.00	Facility		$2,387.00	$10,289.00	$22,788.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,163.40 / $1,366.38 / $7,102.53	Professional		$1,163.40	$1,366.38	$7,102.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $9,771.00 / $21,405.00	Facility		$2,873.70	$9,771.00	$21,405.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,320.76 / $1,679.78 / $3,452.20	Professional		$1,320.76	$1,679.78	$3,452.20
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $5,487.90	Facility		$63.90	$100.00	$5,487.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $999.96 / $1,443.60 / $3,372.94	Professional		$999.96	$1,443.60	$3,372.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $766.00 / $5,431.00	Facility		$633.00	$766.00	$5,431.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,201.20 / $1,682.04 / $3,729.20	Professional		$1,201.20	$1,682.04	$3,729.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $843.26 / $1,276.09 / $1,908.99	Professional		$843.26	$1,276.09	$1,908.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,251.04 / $1,629.64 / $3,005.75	Professional		$1,251.04	$1,629.64	$3,005.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,413.00 / $10,246.71 / $12,661.92	Facility		$5,413.00	$10,246.71	$12,661.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,680.64 / $9,909.92 / $11,847.38	Professional		$9,680.64	$9,909.92	$11,847.38
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 $1,303.84 / $1,685.50 / $2,594.80	Facility		$1,303.84	$1,685.50	$2,594.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,217.77 / $1,769.23 / $3,675.46	Professional		$1,217.77	$1,769.23	$3,675.46
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,406.99 / $4,406.99 / $4,406.99	Professional		$4,406.99	$4,406.99	$4,406.99
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $843.26 / $1,331.19 / $1,627.01	Professional		$843.26	$1,331.19	$1,627.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $4,675.00 / $20,279.00	Facility		$1,204.00	$4,675.00	$20,279.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,085.40 / $1,493.73 / $3,217.00	Professional		$1,085.40	$1,493.73	$3,217.00