Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $771.60	Facility		$120.00	$120.00	$771.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $120.00 / $771.60	Professional		$102.00	$120.00	$771.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.62 / $270.14 / $609.60	Facility		$128.62	$270.14	$609.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $11.36 / $156.00	Professional		$8.91	$11.36	$156.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $80.50 / $100.00 / $338.40	Facility		$80.50	$100.00	$338.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $90.61 / $227.78	Professional		$63.43	$90.61	$227.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.22 / $207.48 / $401.70	Facility		$77.22	$207.48	$401.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.92 / $103.23 / $324.51	Professional		$63.92	$103.23	$324.51
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $132.00 / $162.00	Professional		$120.00	$132.00	$162.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $138.00 / $264.00	Professional		$108.00	$138.00	$264.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $208.80 / $811.07 / $811.07	Facility		$208.80	$811.07	$811.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $600.00 / $900.00	Professional		$600.00	$600.00	$900.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $96.00 / $150.00 / $344.84	Facility		$96.00	$150.00	$344.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.42 / $138.00 / $240.00	Professional		$79.42	$138.00	$240.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $421.20 / $421.20 / $421.20	Professional		$421.20	$421.20	$421.20
United Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $50.88 / $264.95	Professional		$50.40	$50.88	$264.95