Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $475.00 / $1,826.00 / $3,183.05	Facility		$475.00	$1,826.00	$3,183.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $2,259.21	Professional		$370.50	$475.00	$2,259.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.54 / $614.00 / $1,920.70	Facility		$180.54	$614.00	$1,920.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $445.07 / $710.71 / $1,433.55	Professional		$445.07	$710.71	$1,433.55
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.90 / $563.23 / $6,355.22	Facility		$59.90	$563.23	$6,355.22
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $360.09 / $550.70 / $1,328.85	Professional		$360.09	$550.70	$1,328.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.27 / $1,114.44 / $3,901.35	Facility		$281.27	$1,114.44	$3,901.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $345.87 / $677.93 / $1,332.49	Professional		$345.87	$677.93	$1,332.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $481.32 / $529.45 / $649.78	Professional		$481.32	$529.45	$649.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.00 / $475.66 / $853.00	Professional		$355.00	$475.66	$853.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,446.24 / $3,446.24 / $3,637.60	Facility		$3,446.24	$3,446.24	$3,637.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,246.14 / $4,344.14 / $4,344.14	Professional		$4,246.14	$4,344.14	$4,344.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $252.63	Professional		$32.34	$32.34	$252.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $388.96 / $522.75 / $1,026.52	Facility		$388.96	$522.75	$1,026.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $370.20 / $760.91 / $1,219.83	Professional		$370.20	$760.91	$1,219.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,482.97 / $1,482.97 / $1,482.97	Professional		$1,482.97	$1,482.97	$1,482.97
United Facility/Professional Facility Modifier Low / Median / High Price $507.65 / $507.65 / $882.70	Facility		$507.65	$507.65	$882.70
United Facility/Professional Professional Modifier Low / Median / High Price $383.76 / $569.88 / $1,223.55	Professional		$383.76	$569.88	$1,223.55