Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.93 / $600.00 / $5,267.48	Facility		$453.93	$600.00	$5,267.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $453.93 / $453.93 / $3,858.00	Professional		$453.93	$453.93	$3,858.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $554.28 / $1,077.72 / $2,958.00	Facility		$554.28	$1,077.72	$2,958.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.20 / $570.90 / $1,141.81	Professional		$54.20	$570.90	$1,141.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $1,078.56 / $3,910.56	Facility		$98.20	$1,078.56	$3,910.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $272.91 / $389.87 / $1,171.55	Professional		$272.91	$389.87	$1,171.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.52 / $1,037.40 / $2,008.50	Facility		$400.52	$1,037.40	$2,008.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.08 / $399.65 / $1,744.64	Professional		$321.08	$399.65	$1,744.64
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $479.36 / $600.00 / $810.00	Professional		$479.36	$600.00	$810.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $690.00 / $1,308.00	Professional		$540.00	$690.00	$1,308.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,044.00 / $2,850.00 / $2,850.00	Facility		$1,044.00	$2,850.00	$2,850.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,000.00 / $4,500.00	Professional		$3,000.00	$3,000.00	$4,500.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $720.00 / $720.00	Professional		$720.00	$720.00	$720.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $453.93 / $720.00 / $1,724.19	Facility		$453.93	$720.00	$1,724.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $352.59 / $690.00 / $1,350.41	Professional		$352.59	$690.00	$1,350.41
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,106.00 / $2,106.00 / $2,106.00	Professional		$2,106.00	$2,106.00	$2,106.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $480.00 / $540.00 / $814.91	Professional		$480.00	$540.00	$814.91
United Facility/Professional Professional Modifier Low / Median / High Price $252.00 / $254.70 / $1,192.08	Professional		$252.00	$254.70	$1,192.08