Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.57 / $842.62 / $2,724.00	Facility		$161.57	$842.62	$2,724.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.55 / $152.69 / $785.20	Professional		$113.55	$152.69	$785.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.17 / $570.00 / $876.00	Facility		$76.17	$570.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.11 / $234.75 / $443.81	Professional		$177.11	$234.75	$443.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $230.94 / $1,050.88	Facility		$59.40	$230.94	$1,050.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $166.33 / $237.89 / $532.09	Professional		$166.33	$237.89	$532.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.05 / $773.83 / $1,600.83	Facility		$112.05	$773.83	$1,600.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.67 / $205.60 / $396.91	Professional		$120.67	$205.60	$396.91
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $157.05 / $212.02	Professional		$103.83	$157.05	$212.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.90 / $161.91 / $295.25	Professional		$125.90	$161.91	$295.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $466.30 / $668.80 / $668.80	Facility		$466.30	$668.80	$668.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.00 / $1,174.00 / $1,174.00	Professional		$1,174.00	$1,174.00	$1,174.00
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 $128.22 / $214.31 / $773.83	Facility		$128.22	$214.31	$773.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $122.89 / $212.48 / $384.87	Professional		$122.89	$212.48	$384.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $451.82 / $451.82 / $451.82	Professional		$451.82	$451.82	$451.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $127.00 / $174.63 / $253.18	Professional		$127.00	$174.63	$253.18
United Facility/Professional Facility Modifier Low / Median / High Price $111.02 / $111.02 / $111.02	Facility		$111.02	$111.02	$111.02
United Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $157.18 / $384.97	Professional		$118.41	$157.18	$384.97