Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $812.83	Professional		$112.20	$194.98	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $162.18 / $223.87	Facility		$138.04	$162.18	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $218.78 / $457.09	Professional		$117.49	$218.78	$457.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $138.04 / $389.05	Professional		$112.20	$138.04	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $489.78	Professional		$91.20	$151.36	$489.78
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $141.25 / $190.55	Professional		$125.89	$141.25	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $154.88 / $245.47	Professional		$125.89	$154.88	$245.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,148.15	Professional		$1,047.13	$1,047.13	$1,148.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $169.82 / $363.08	Facility		$45.71	$169.82	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $186.21 / $489.78	Professional		$93.33	$186.21	$489.78
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $1,862.09	Professional		$112.20	$112.20	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $346.74	Professional		$85.11	$120.23	$346.74