Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,818.38 / $8,912.51	Facility		$724.44	$2,818.38	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,071.52 / $8,912.51	Professional		$724.44	$1,071.52	$8,912.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,162.28 / $6,760.83	Facility		$630.96	$3,162.28	$6,760.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $2,818.38 / $5,888.44	Professional		$537.03	$2,818.38	$5,888.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $3,019.95 / $3,801.89	Facility		$977.24	$3,019.95	$3,801.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,023.29 / $2,630.27	Professional		$794.33	$1,023.29	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $2,344.23 / $4,570.88	Facility		$912.01	$2,344.23	$4,570.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $891.25 / $2,630.27	Professional		$676.08	$891.25	$2,630.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,479.11 / $1,819.70	Professional		$1,348.96	$1,479.11	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $2,344.23	Professional		$1,071.52	$1,412.54	$2,344.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,456.54 / $6,456.54	Facility		$6,456.54	$6,456.54	$6,456.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,760.83 / $10,232.93 / $10,232.93	Professional		$6,760.83	$10,232.93	$10,232.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,348.96 / $1,348.96	Professional		$676.08	$1,348.96	$1,348.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,412.54 / $3,388.44	Facility		$812.83	$1,412.54	$3,388.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,445.44 / $2,691.53	Professional		$724.44	$1,445.44	$2,691.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Professional		$4,786.30	$4,786.30	$4,786.30
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $741.31 / $1,348.96	Facility		$602.56	$741.31	$1,348.96
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $2,290.87	Professional		$562.34	$562.34	$2,290.87