Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,067.11 / $2,571.38 / $2,975.51	Facility		$1,067.11	$2,571.38	$2,975.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,028.55 / $1,067.11 / $1,833.31	Professional		$1,028.55	$1,067.11	$1,833.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,136.66 / $1,814.04 / $4,066.45	Facility		$1,136.66	$1,814.04	$4,066.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $773.40 / $1,092.83 / $1,527.39	Professional		$773.40	$1,092.83	$1,527.39
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $1,285.69	Facility		$77.09	$100.00	$1,285.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,157.11 / $1,157.11 / $2,820.71	Professional		$1,157.11	$1,157.11	$2,820.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,092.83 / $1,092.83 / $1,092.83	Facility		$1,092.83	$1,092.83	$1,092.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,092.83 / $1,092.83 / $1,092.83	Professional		$1,092.83	$1,092.83	$1,092.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,075.86 / $1,075.86 / $1,452.42	Professional		$1,075.86	$1,075.86	$1,452.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $801.00 / $1,302.00 / $3,060.00	Professional		$801.00	$1,302.00	$3,060.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,244.38 / $5,678.45 / $5,678.45	Facility		$1,244.38	$5,678.45	$5,678.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,885.62 / $4,885.62 / $5,785.61	Professional		$4,885.62	$4,885.62	$5,785.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $2,467.83 / $2,467.83	Professional		$60.00	$2,467.83	$2,467.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $553.71 / $1,028.55 / $1,135.69	Facility		$553.71	$1,028.55	$1,135.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,092.83 / $1,092.83 / $1,339.26	Professional		$1,092.83	$1,092.83	$1,339.26
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,021.53 / $2,021.53 / $2,021.53	Professional		$2,021.53	$2,021.53	$2,021.53
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,071.41 / $1,392.83 / $1,607.12	Professional		$1,071.41	$1,392.83	$1,607.12
United Facility/Professional Professional Modifier Low / Median / High Price $1,071.41 / $1,071.41 / $1,912.71	Professional		$1,071.41	$1,071.41	$1,912.71