Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $732.32 / $6,264.00 / $17,030.00	Facility		$732.32	$6,264.00	$17,030.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $12,631.13 / $12,631.13 / $12,631.13	Facility	50	$12,631.13	$12,631.13	$12,631.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $571.97 / $674.37 / $1,587.49	Professional		$571.97	$674.37	$1,587.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $6,945.00 / $13,707.00	Facility		$2,143.00	$6,945.00	$13,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $605.26 / $852.66 / $1,736.10	Professional		$605.26	$852.66	$1,736.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $955.66 / $1,133.52 / $1,338.60	Professional	50	$955.66	$1,133.52	$1,338.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $7,833.76	Facility		$66.00	$100.00	$7,833.76
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $461.16 / $658.80 / $1,412.76	Professional		$461.16	$658.80	$1,412.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $571.29 / $1,458.73 / $1,988.34	Facility		$571.29	$1,458.73	$1,988.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $593.57 / $835.58 / $1,741.26	Professional		$593.57	$835.58	$1,741.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $462.02 / $926.80 / $1,268.20	Professional		$462.02	$926.80	$1,268.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $624.63 / $876.34 / $1,556.39	Professional		$624.63	$876.34	$1,556.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,449.12 / $4,572.72 / $26,542.00	Facility		$4,449.12	$4,572.72	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,606.00 / $5,606.00 / $6,390.00	Professional		$5,606.00	$5,606.00	$6,390.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $674.37 / $902.24 / $1,362.14	Facility		$674.37	$902.24	$1,362.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $598.95 / $904.10 / $1,876.60	Professional		$598.95	$904.10	$1,876.60
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,147.39 / $2,147.39 / $2,554.92	Professional		$2,147.39	$2,147.39	$2,554.92
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $600.63 / $785.44 / $1,044.13	Professional		$600.63	$785.44	$1,044.13
United Facility/Professional Facility Modifier Low / Median / High Price $3,693.00 / $7,042.00 / $14,636.00	Facility		$3,693.00	$7,042.00	$14,636.00
United Facility/Professional Professional Modifier Low / Median / High Price $590.72 / $768.60 / $1,717.12	Professional		$590.72	$768.60	$1,717.12