Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,150.00 / $1,872.00 / $6,018.48	Facility		$1,150.00	$1,872.00	$6,018.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $622.44 / $1,150.00 / $6,018.48	Professional		$622.44	$1,150.00	$6,018.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $434.15 / $1,617.31 / $4,614.47	Facility		$434.15	$1,617.31	$4,614.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.40 / $2,756.02 / $5,825.92	Professional		$374.40	$2,756.02	$5,825.92
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $676.73 / $2,639.52	Facility		$92.60	$676.73	$2,639.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $425.88 / $608.40 / $1,521.30	Professional		$425.88	$608.40	$1,521.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $636.24 / $1,317.79 / $3,063.29	Facility		$636.24	$1,317.79	$3,063.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.40 / $620.09 / $1,807.75	Professional		$374.40	$620.09	$1,807.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $936.00 / $1,029.59 / $1,497.60	Professional		$936.00	$1,029.59	$1,497.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $748.80 / $1,029.59 / $1,649.00	Professional		$748.80	$1,029.59	$1,649.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,497.60 / $4,446.00 / $4,446.00	Facility		$1,497.60	$4,446.00	$4,446.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,680.00 / $4,680.00 / $7,020.00	Professional		$4,680.00	$4,680.00	$7,020.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $468.00 / $468.00 / $655.20	Professional		$468.00	$468.00	$655.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $561.60 / $1,123.20 / $2,235.42	Facility		$561.60	$1,123.20	$2,235.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $550.79 / $1,001.70 / $1,807.75	Professional		$550.79	$1,001.70	$1,807.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,285.36 / $3,285.36 / $3,285.36	Professional		$3,285.36	$3,285.36	$3,285.36
United Facility/Professional Professional Modifier Low / Median / High Price $393.12 / $409.00 / $1,853.28	Professional		$393.12	$409.00	$1,853.28