Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $23.99 / $562.34	Professional		$16.98	$23.99	$562.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $213.80 / $549.54	Facility		$169.82	$213.80	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $218.78 / $741.31	Professional		$38.90	$218.78	$741.31
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $467.74 / $575.44	Facility		$147.91	$467.74	$575.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $102.33	Professional		$25.70	$37.15	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $91.20 / $660.69	Professional		$12.30	$91.20	$660.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $23.44 / $660.69	Professional		$17.38	$23.44	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $389.05 / $812.83	Professional		$15.49	$389.05	$812.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,467.37 / $3,467.37	Professional		$2,951.21	$3,467.37	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $575.44	Professional		$346.74	$346.74	$575.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $28.84 / $630.96	Facility		$15.49	$28.84	$630.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $85.11 / $758.58	Professional		$12.30	$85.11	$758.58
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $1,096.48	Professional		$61.66	$61.66	$1,096.48
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $331.13 / $501.19	Facility		$316.23	$331.13	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $77.62 / $398.11	Professional		$16.22	$77.62	$398.11