Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $21,373.30	Facility		$1,000.00	$1,000.00	$21,373.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $21,373.30	Professional		$1,000.00	$1,000.00	$21,373.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $5,743.54 / $16,387.32	Facility		$614.00	$5,743.54	$16,387.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,329.60 / $2,838.70 / $6,945.17	Professional		$1,329.60	$2,838.70	$6,945.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $2,403.25 / $9,373.68	Facility		$92.60	$2,403.25	$9,373.68
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,512.42 / $2,160.60 / $5,402.58	Professional		$1,512.42	$2,160.60	$5,402.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,259.46 / $4,679.85 / $10,878.62	Facility		$2,259.46	$4,679.85	$10,878.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,846.63 / $3,909.02 / $6,420.81	Professional		$1,846.63	$3,909.02	$6,420.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3,324.00 / $3,656.40 / $5,318.40	Professional		$3,324.00	$3,656.40	$5,318.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,659.20 / $3,656.40 / $5,817.00	Professional		$2,659.20	$3,656.40	$5,817.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,318.40 / $15,789.00 / $15,789.00	Facility		$5,318.40	$15,789.00	$15,789.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $16,620.00 / $16,620.00 / $24,930.00	Professional		$16,620.00	$16,620.00	$24,930.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,662.00 / $1,662.00 / $2,326.80	Professional		$1,662.00	$1,662.00	$2,326.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,994.40 / $3,370.54 / $7,937.54	Facility		$1,994.40	$3,370.54	$7,937.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,994.40 / $3,556.52 / $6,420.81	Professional		$1,994.40	$3,556.52	$6,420.81
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $11,667.24 / $11,667.24 / $11,667.24	Professional		$11,667.24	$11,667.24	$11,667.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,396.08 / $3,324.00 / $3,324.00	Facility		$1,396.08	$3,324.00	$3,324.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,396.08 / $1,452.49 / $5,989.85	Professional		$1,396.08	$1,452.49	$5,989.85