Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,698.24 / $2,454.71	Facility		$199.53	$1,698.24	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $1,698.24	Professional		$173.78	$208.93	$1,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $588.84 / $1,288.25	Facility		$117.49	$588.84	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $239.88 / $524.81	Professional		$199.53	$239.88	$524.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $575.44 / $724.44	Facility		$186.21	$575.44	$724.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $512.86	Professional		$151.36	$204.17	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $446.68 / $870.96	Facility		$177.83	$446.68	$870.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $741.31	Professional		$138.04	$169.82	$741.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $281.84 / $346.74	Professional		$257.04	$281.84	$346.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $281.84 / $446.68	Professional		$229.09	$281.84	$446.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,905.46 / $1,905.46	Professional		$1,288.25	$1,905.46	$1,905.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $309.03 / $758.58	Facility		$204.17	$309.03	$758.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $257.04 / $707.95	Professional		$138.04	$257.04	$707.95
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $257.04 / $257.04	Facility		$107.15	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $489.78	Professional		$89.13	$109.65	$489.78