Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $10,000.00 / $21,379.62	Facility		$4,168.69	$10,000.00	$21,379.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,584.89 / $7,413.10	Professional		$1,023.29	$1,584.89	$7,413.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $11,220.18 / $17,782.79	Facility		$6,456.54	$11,220.18	$17,782.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,778.28 / $3,981.07	Professional		$1,230.27	$1,778.28	$3,981.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $4,570.88 / $12,302.69	Facility		$66.07	$4,570.88	$12,302.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $3,715.35	Professional		$1,096.48	$1,513.56	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $2,238.72 / $3,090.30	Facility		$794.33	$2,238.72	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,548.82 / $3,311.31	Professional		$1,096.48	$1,548.82	$3,311.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,412.54 / $1,905.46	Professional		$851.14	$1,412.54	$1,905.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,445.44 / $2,754.23	Professional		$1,122.02	$1,445.44	$2,754.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,912.51 / $42,657.95 / $42,657.95	Facility		$8,912.51	$42,657.95	$42,657.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,549.93 / $10,715.19 / $10,715.19	Professional		$9,549.93	$10,715.19	$10,715.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Professional		$1,862.09	$1,862.09	$1,862.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,621.81 / $2,398.83	Facility		$1,230.27	$1,621.81	$2,398.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,584.89 / $3,388.44	Professional		$1,122.02	$1,584.89	$3,388.44
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Professional		$4,168.69	$4,168.69	$4,168.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,288.25 / $1,819.70	Professional		$1,071.52	$1,288.25	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $10,000.00 / $20,892.96	Facility		$5,248.07	$10,000.00	$20,892.96
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,258.93 / $2,754.23	Professional		$977.24	$1,258.93	$2,754.23