Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $831.76 / $1,819.70	Facility		$204.17	$831.76	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $851.14	Professional		$128.82	$177.83	$851.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $33.11 / $707.95	Facility		$29.51	$33.11	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $562.34	Professional		$141.25	$208.93	$562.34
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $457.09 / $1,000.00	Facility		$69.18	$457.09	$1,000.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $263.03 / $588.84	Professional		$204.17	$263.03	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $1,230.27 / $3,890.45	Facility		$263.03	$1,230.27	$3,890.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $501.19	Professional		$117.49	$213.80	$501.19
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $177.83 / $199.53	Professional		$87.10	$177.83	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $346.74	Professional		$134.90	$177.83	$346.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $112.20 / $134.90	Professional		$25.12	$112.20	$134.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $234.42 / $1,862.09	Facility		$144.54	$234.42	$1,862.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $501.19	Professional		$117.49	$213.80	$501.19
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $208.93	Professional		$128.82	$165.96	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $660.69 / $1,000.00	Facility		$630.96	$660.69	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $478.63	Professional		$109.65	$177.83	$478.63