Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $825.00 / $5,111.85	Facility		$825.00	$825.00	$5,111.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $556.50 / $825.00 / $5,111.85	Professional		$556.50	$825.00	$5,111.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $1,269.84 / $3,661.86	Facility		$645.00	$1,269.84	$3,661.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $500.00 / $1,043.67	Professional		$400.00	$500.00	$1,043.67
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $574.79 / $2,241.90	Facility		$92.60	$574.79	$2,241.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $385.00 / $550.00 / $1,359.60	Professional		$385.00	$550.00	$1,359.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $532.37 / $888.81 / $1,937.81	Facility		$532.37	$888.81	$1,937.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.35 / $675.08 / $1,535.44	Professional		$425.35	$675.08	$1,535.44
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $636.00 / $795.00 / $1,073.25	Professional		$636.00	$795.00	$1,073.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $636.00 / $874.50 / $1,391.25	Professional		$636.00	$874.50	$1,391.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,272.00 / $3,776.25 / $3,776.25	Facility		$1,272.00	$3,776.25	$3,776.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,975.00 / $3,975.00 / $5,962.50	Professional		$3,975.00	$3,975.00	$5,962.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $397.50 / $397.50 / $397.50	Professional		$397.50	$397.50	$397.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $397.50 / $816.47 / $1,400.39	Facility		$397.50	$816.47	$1,400.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $477.00 / $850.71 / $1,535.44	Professional		$477.00	$850.71	$1,535.44
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,790.45 / $2,790.45 / $2,790.45	Professional		$2,790.45	$2,790.45	$2,790.45
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $636.00 / $712.32 / $1,081.20	Professional		$636.00	$712.32	$1,081.20
United Facility/Professional Professional Modifier Low / Median / High Price $333.90 / $333.90 / $1,527.20	Professional		$333.90	$333.90	$1,527.20