Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.50 / $301.64 / $1,142.03	Facility		$112.50	$301.64	$1,142.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.39 / $130.96 / $676.24	Professional		$100.39	$130.96	$676.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.50 / $282.50 / $628.70	Facility		$134.50	$282.50	$628.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $159.06 / $372.59	Professional		$70.62	$159.06	$372.59
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.40 / $229.86 / $1,562.04	Facility		$59.40	$229.86	$1,562.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $77.25 / $110.36 / $337.72	Professional		$77.25	$110.36	$337.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.17 / $215.34 / $436.89	Facility		$92.17	$215.34	$436.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.48 / $134.49 / $617.74	Professional		$81.48	$134.49	$617.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $107.81 / $125.49 / $169.41	Professional		$107.81	$125.49	$169.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.94 / $144.31 / $284.39	Professional		$112.94	$144.31	$284.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $218.35 / $596.08 / $704.00	Facility		$218.35	$596.08	$704.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,215.00 / $1,215.00 / $1,215.00	Professional		$1,215.00	$1,215.00	$1,215.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.59 / $150.59 / $150.59	Professional		$150.59	$150.59	$150.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $121.73 / $208.97 / $525.00	Facility		$121.73	$208.97	$525.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.87 / $156.86 / $381.92	Professional		$91.87	$156.86	$381.92
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $440.46 / $440.46 / $440.46	Professional		$440.46	$440.46	$440.46
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $100.39 / $128.00 / $213.33	Professional		$100.39	$128.00	$213.33
United Facility/Professional Facility Modifier Low / Median / High Price $735.00 / $735.00 / $735.00	Facility		$735.00	$735.00	$735.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.29 / $107.12 / $377.11	Professional		$75.29	$107.12	$377.11