Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $558.00 / $825.00 / $1,793.97	Facility		$558.00	$825.00	$1,793.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.50 / $825.00 / $1,793.97	Professional		$139.50	$825.00	$1,793.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $259.86 / $558.36 / $1,375.47	Facility		$259.86	$558.36	$1,375.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.60 / $118.29 / $1,180.17	Professional		$111.60	$118.29	$1,180.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $201.72 / $786.78	Facility		$92.60	$201.72	$786.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $63.76 / $91.09 / $259.00	Professional		$63.76	$91.09	$259.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.54 / $482.39 / $933.95	Facility		$179.54	$482.39	$933.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $185.49 / $575.91	Professional		$76.09	$185.49	$575.91
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $279.00 / $376.65	Professional		$112.90	$279.00	$376.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.10 / $320.85 / $544.04	Professional		$251.10	$320.85	$544.04
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $485.46 / $1,325.25 / $1,325.25	Facility		$485.46	$1,325.25	$1,325.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,395.00 / $1,395.00 / $2,092.50	Professional		$1,395.00	$1,395.00	$2,092.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $195.30 / $195.30 / $195.30	Professional		$195.30	$195.30	$195.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $186.93 / $362.70 / $874.50	Facility		$186.93	$362.70	$874.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.63 / $306.89 / $572.87	Professional		$127.63	$306.89	$572.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $979.29 / $979.29 / $979.29	Professional		$979.29	$979.29	$979.29
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $115.16 / $191.93 / $279.00	Professional		$115.16	$191.93	$279.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.40 / $121.91 / $863.87	Professional		$60.40	$121.91	$863.87