Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,429.89 / $4,881.39 / $5,479.86	Facility		$2,429.89	$4,881.39	$5,479.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,454.19 / $5,198.92	Professional		$2,429.89	$2,454.19	$5,198.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,562.73 / $3,881.26 / $9,521.28	Facility		$2,562.73	$3,881.26	$9,521.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,440.69 / $5,076.64	Professional		$2,429.89	$2,440.69	$5,076.64
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.70 / $100.00 / $3,360.86	Facility		$77.70	$100.00	$3,360.86
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $2,475.73 / $2,475.73 / $5,893.43	Professional		$2,475.73	$2,475.73	$5,893.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,292.35 / $2,292.35 / $2,429.89	Facility		$2,292.35	$2,292.35	$2,429.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $2,974.42	Professional		$2,429.89	$2,429.89	$2,974.42
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,413.36 / $2,441.48 / $3,258.03	Professional		$2,413.36	$2,441.48	$3,258.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,186.90 / $2,915.87 / $4,641.09	Professional		$2,186.90	$2,915.87	$4,641.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,232.21 / $11,906.46 / $12,207.45	Facility		$3,232.21	$11,906.46	$12,207.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,655.19 / $10,655.19 / $10,655.19	Professional		$10,655.19	$10,655.19	$10,655.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $4,947.38 / $4,947.38	Professional		$60.00	$4,947.38	$4,947.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,429.89 / $2,527.09 / $4,137.58	Facility		$2,429.89	$2,527.09	$4,137.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $3,016.70	Professional		$2,429.89	$2,429.89	$3,016.70
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,532.08 / $3,532.08 / $3,532.08	Professional		$3,532.08	$3,532.08	$3,532.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,943.91 / $2,429.89 / $3,644.84	Professional		$1,943.91	$2,429.89	$3,644.84
United Facility/Professional Facility Modifier Low / Median / High Price $5,905.73 / $6,223.97 / $6,223.97	Facility		$5,905.73	$6,223.97	$6,223.97
United Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $4,432.12	Professional		$2,429.89	$2,429.89	$4,432.12