Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.50 / $203.50 / $1,943.76	Facility		$173.50	$203.50	$1,943.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $173.50 / $1,308.51	Professional		$162.80	$173.50	$1,308.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.00 / $414.45 / $1,003.26	Facility		$203.00	$414.45	$1,003.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.40 / $681.81 / $1,373.33	Professional		$81.40	$681.81	$1,373.33
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $147.13 / $573.87	Facility		$92.60	$147.13	$573.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.70 / $143.86 / $883.03	Professional		$100.70	$143.86	$883.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.76 / $351.86 / $681.24	Facility		$147.76	$351.86	$681.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $147.51 / $591.32	Professional		$108.90	$147.51	$591.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $203.50 / $274.73	Professional		$162.80	$203.50	$274.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $183.15 / $234.03 / $443.63	Professional		$183.15	$234.03	$443.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $354.09 / $966.63 / $966.63	Facility		$354.09	$966.63	$966.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,017.50 / $1,017.50 / $1,526.25	Professional		$1,017.50	$1,017.50	$1,526.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $244.20 / $244.20 / $244.20	Professional		$244.20	$244.20	$244.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.35 / $248.11 / $584.80	Facility		$165.35	$248.11	$584.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.24 / $234.03 / $497.94	Professional		$120.24	$234.03	$497.94
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $714.28 / $714.28 / $714.28	Professional		$714.28	$714.28	$714.28
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $162.80 / $183.15 / $276.76	Professional		$162.80	$183.15	$276.76
United Facility/Professional Facility Modifier Low / Median / High Price $203.50 / $203.50 / $203.50	Facility		$203.50	$203.50	$203.50
United Facility/Professional Professional Modifier Low / Median / High Price $85.47 / $93.10 / $441.00	Professional		$85.47	$93.10	$441.00