Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,414.64 / $9,962.79 / $22,689.30	Facility		$2,414.64	$9,962.79	$22,689.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,846.49 / $2,527.19 / $20,833.20	Professional		$1,846.49	$2,527.19	$20,833.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $5,819.69 / $15,973.20	Facility		$614.00	$5,819.69	$15,973.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,360.80 / $4,860.00	Professional		$1,296.00	$1,360.80	$4,860.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $2,342.52 / $9,136.79	Facility		$92.60	$2,342.52	$9,136.79
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,474.20 / $2,106.00 / $5,294.27	Professional		$1,474.20	$2,106.00	$5,294.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,106.00 / $5,559.84 / $10,845.90	Facility		$2,106.00	$5,559.84	$10,845.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,532.50 / $2,527.32 / $8,880.71	Professional		$1,532.50	$2,527.32	$8,880.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3,240.00 / $3,564.00 / $4,374.00	Professional		$3,240.00	$3,564.00	$4,374.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,916.00 / $3,726.00 / $6,318.00	Professional		$2,916.00	$3,726.00	$6,318.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,637.60 / $15,390.00 / $15,390.00	Facility		$5,637.60	$15,390.00	$15,390.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $16,200.00 / $16,200.00 / $24,300.00	Professional		$16,200.00	$16,200.00	$24,300.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,268.00 / $2,268.00 / $2,268.00	Professional		$2,268.00	$2,268.00	$2,268.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,414.64 / $3,888.00 / $9,293.78	Facility		$2,414.64	$3,888.00	$9,293.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,903.60 / $3,564.00 / $6,480.00	Professional		$1,903.60	$3,564.00	$6,480.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $11,372.40 / $11,372.40 / $11,372.40	Professional		$11,372.40	$11,372.40	$11,372.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,592.00 / $3,304.80 / $5,508.00	Professional		$2,592.00	$3,304.80	$5,508.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,193.11 / $1,463.54 / $6,437.23	Professional		$1,193.11	$1,463.54	$6,437.23