Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.08 / $314.92 / $538.48	Facility		$72.08	$314.92	$538.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.92 / $73.88 / $315.00	Professional		$58.92	$73.88	$315.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.58 / $92.65 / $376.00	Facility		$74.58	$92.65	$376.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.45 / $97.09 / $261.77	Professional		$65.45	$97.09	$261.77
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $142.34 / $254.18	Facility		$96.60	$142.34	$254.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $49.02 / $69.44 / $111.32	Professional		$49.02	$69.44	$111.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $72.00 / $250.00	Facility		$60.00	$72.00	$250.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $92.79 / $231.57	Professional		$55.86	$92.79	$231.57
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $125.00 / $156.25	Professional		$67.73	$125.00	$156.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.92 / $111.89 / $230.00	Professional		$83.92	$111.89	$230.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $197.61 / $470.81 / $531.48	Facility		$197.61	$470.81	$531.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $141.06 / $637.99 / $846.75	Professional		$141.06	$637.99	$846.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $70.00 / $143.05	Professional		$32.34	$70.00	$143.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $120.38 / $155.53	Facility		$70.13	$120.38	$155.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $97.22 / $231.57	Professional		$55.86	$97.22	$231.57
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $300.14 / $300.14 / $300.14	Professional		$300.14	$300.14	$300.14
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Facility		$300.00	$300.00	$300.00
United Facility/Professional Professional Modifier Low / Median / High Price $67.64 / $92.75 / $233.54	Professional		$67.64	$92.75	$233.54