Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.60 / $2,116.00 / $4,116.17	Facility		$489.60	$2,116.00	$4,116.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.81 / $562.66 / $3,567.08	Professional		$436.81	$562.66	$3,567.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.14 / $96.33 / $2,914.00	Facility		$80.14	$96.33	$2,914.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.08 / $502.64 / $1,194.89	Professional		$257.08	$502.64	$1,194.89
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $269.48 / $1,284.67	Facility		$59.40	$269.48	$1,284.67
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $168.34 / $248.50 / $623.69	Professional		$168.34	$248.50	$623.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,011.73 / $1,309.17 / $2,758.09	Facility		$1,011.73	$1,309.17	$2,758.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.48 / $662.61 / $1,804.79	Professional		$291.48	$662.61	$1,804.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $839.12 / $923.03 / $1,132.81	Professional		$839.12	$923.03	$1,132.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $638.27 / $839.12 / $1,457.10	Professional		$638.27	$839.12	$1,457.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,602.32 / $5,761.44 / $5,991.20	Facility		$4,602.32	$5,761.44	$5,991.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,187.89 / $4,187.89 / $5,361.23	Professional		$4,187.89	$4,187.89	$5,361.23
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 $263.69 / $789.64 / $1,342.59	Facility		$263.69	$789.64	$1,342.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $304.14 / $702.25 / $1,645.84	Professional		$304.14	$702.25	$1,645.84
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,052.54 / $2,052.54 / $2,052.54	Professional		$2,052.54	$2,052.54	$2,052.54
United Facility/Professional Facility Modifier Low / Median / High Price $570.02 / $570.02 / $954.74	Facility		$570.02	$570.02	$954.74
United Facility/Professional Professional Modifier Low / Median / High Price $316.37 / $780.89 / $1,784.17	Professional		$316.37	$780.89	$1,784.17