Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,482.26 / $10,241.79 / $24,112.50	Facility		$2,482.26	$10,241.79	$24,112.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,898.20 / $2,482.26 / $24,112.50	Professional		$1,898.20	$2,482.26	$24,112.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $6,735.75 / $18,487.50	Facility		$614.00	$6,735.75	$18,487.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $1,575.00 / $5,625.00	Professional		$1,500.00	$1,575.00	$5,625.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $2,711.25 / $10,575.00	Facility		$92.60	$2,711.25	$10,575.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,706.25 / $2,437.50 / $6,127.63	Professional		$1,706.25	$2,437.50	$6,127.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,413.13 / $6,435.00 / $12,553.13	Facility		$2,413.13	$6,435.00	$12,553.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,575.48 / $2,924.94 / $10,278.95	Professional		$1,575.48	$2,924.94	$10,278.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $4,125.00 / $5,062.50	Professional		$3,750.00	$4,125.00	$5,062.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,375.00 / $4,312.50 / $8,028.00	Professional		$3,375.00	$4,312.50	$8,028.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,525.00 / $17,812.50 / $17,812.50	Facility		$6,525.00	$17,812.50	$17,812.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $18,750.00 / $18,750.00 / $28,125.00	Professional		$18,750.00	$18,750.00	$28,125.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,625.00 / $2,625.00 / $2,625.00	Professional		$2,625.00	$2,625.00	$2,625.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,530.33 / $4,500.00 / $10,756.69	Facility		$2,530.33	$4,500.00	$10,756.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,996.84 / $4,125.00 / $7,500.00	Professional		$1,996.84	$4,125.00	$7,500.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $13,162.50 / $13,162.50 / $13,162.50	Professional		$13,162.50	$13,162.50	$13,162.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.53 / $1,575.00 / $7,203.75	Professional		$1,226.53	$1,575.00	$7,203.75