Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.40 / $1,211.52 / $3,240.72	Facility		$428.40	$1,211.52	$3,240.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.16 / $428.40 / $3,240.72	Professional		$335.16	$428.40	$3,240.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $312.00 / $876.00 / $2,484.71	Facility		$312.00	$876.00	$2,484.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.60 / $2,756.02 / $5,789.50	Professional		$201.60	$2,756.02	$5,789.50
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $364.39 / $1,421.28	Facility		$92.60	$364.39	$1,421.28
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $229.32 / $327.60 / $819.16	Professional		$229.32	$327.60	$819.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $342.58 / $709.58 / $1,649.47	Facility		$342.58	$709.58	$1,649.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.60 / $360.68 / $948.81	Professional		$201.60	$360.68	$948.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $504.00 / $554.40 / $806.40	Professional		$504.00	$554.40	$806.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $403.20 / $554.40 / $1,041.00	Professional		$403.20	$554.40	$1,041.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $806.40 / $2,394.00 / $2,394.00	Facility		$806.40	$2,394.00	$2,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,520.00 / $2,520.00 / $3,780.00	Professional		$2,520.00	$2,520.00	$3,780.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $252.00 / $252.00 / $352.80	Professional		$252.00	$252.00	$352.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $302.39 / $543.82 / $1,203.45	Facility		$302.39	$543.82	$1,203.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $539.46 / $973.30	Professional		$302.39	$539.46	$973.30
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,769.04 / $1,769.04 / $1,769.04	Professional		$1,769.04	$1,769.04	$1,769.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,850.00 / $1,850.00 / $1,850.00	Facility		$1,850.00	$1,850.00	$1,850.00
United Facility/Professional Professional Modifier Low / Median / High Price $211.68 / $220.23 / $915.21	Professional		$211.68	$220.23	$915.21