Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $207.73 / $1,571.75	Facility		$75.00	$207.73	$1,571.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $97.54 / $1,127.82	Professional		$75.00	$97.54	$1,127.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $179.84 / $357.22 / $876.00	Facility		$179.84	$357.22	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.04 / $73.18 / $231.28	Professional		$69.04	$73.18	$231.28
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $126.81 / $494.63	Facility		$92.60	$126.81	$494.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $116.34 / $225.95	Professional		$81.44	$116.34	$225.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.51 / $303.27 / $587.15	Facility		$119.51	$303.27	$587.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.84 / $119.16 / $509.68	Professional		$93.84	$119.16	$509.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $175.40 / $236.79	Professional		$77.95	$175.40	$236.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.86 / $201.71 / $385.88	Professional		$157.86	$201.71	$385.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $305.20 / $833.15 / $833.15	Facility		$305.20	$833.15	$833.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $877.00 / $877.00 / $1,315.50	Professional		$877.00	$877.00	$1,315.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $210.49 / $210.49 / $210.49	Professional		$210.49	$210.49	$210.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.01 / $210.48 / $504.04	Facility		$114.01	$210.48	$504.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.13 / $192.94 / $402.87	Professional		$103.13	$192.94	$402.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $615.65 / $615.65 / $615.65	Professional		$615.65	$615.65	$615.65
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $132.53 / $175.40	Professional		$79.52	$132.53	$175.40
United Facility/Professional Professional Modifier Low / Median / High Price $73.67 / $79.81 / $387.28	Professional		$73.67	$79.81	$387.28