Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $440.00 / $440.00 / $5,767.71	Facility		$440.00	$440.00	$5,767.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $440.00 / $457.77 / $5,767.71	Professional		$440.00	$457.77	$5,767.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.06 / $1,549.93 / $4,422.21	Facility		$416.06	$1,549.93	$4,422.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.80 / $376.74 / $2,287.35	Professional		$358.80	$376.74	$2,287.35
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $648.53 / $2,529.54	Facility		$92.60	$648.53	$2,529.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $408.14 / $583.04 / $1,457.92	Professional		$408.14	$583.04	$1,457.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $583.04 / $1,262.89 / $2,935.66	Facility		$583.04	$1,262.89	$2,935.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $477.71 / $1,054.86 / $1,732.93	Professional		$477.71	$1,054.86	$1,732.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $897.00 / $897.00 / $1,210.95	Professional		$897.00	$897.00	$1,210.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $717.60 / $986.70 / $1,621.00	Professional		$717.60	$986.70	$1,621.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,435.20 / $4,260.75 / $4,260.75	Facility		$1,435.20	$4,260.75	$4,260.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,485.00 / $4,485.00 / $6,727.50	Professional		$4,485.00	$4,485.00	$6,727.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $538.20 / $538.20 / $1,076.40	Professional		$538.20	$538.20	$1,076.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $448.50 / $914.94 / $2,141.96	Facility		$448.50	$914.94	$2,141.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $538.20 / $959.60 / $1,732.93	Professional		$538.20	$959.60	$1,732.93
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,148.47 / $3,148.47 / $3,148.47	Professional		$3,148.47	$3,148.47	$3,148.47
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $717.60 / $897.00 / $1,524.90	Professional		$717.60	$897.00	$1,524.90
United Facility/Professional Professional Modifier Low / Median / High Price $376.74 / $403.65 / $1,628.86	Professional		$376.74	$403.65	$1,628.86