Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $218.78 / $354.81	Facility		$141.25	$218.78	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $107.15 / $181.97	Professional		$104.71	$107.15	$181.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $125.89 / $316.23	Facility		$107.15	$125.89	$316.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $165.96	Professional		$100.00	$104.71	$165.96
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $107.15 / $218.78	Facility		$83.18	$107.15	$218.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $223.87	Professional		$104.71	$123.03	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $104.71	Facility		$100.00	$100.00	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $114.82	Professional		$104.71	$104.71	$114.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $134.90	Professional		$100.00	$100.00	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $181.97	Professional		$95.50	$114.82	$181.97
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $114.82 / $186.21	Facility		$104.71	$114.82	$186.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $128.82	Professional		$104.71	$104.71	$128.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $177.83	Professional		$85.11	$114.82	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $288.40 / $288.40	Facility		$104.71	$288.40	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $125.89	Professional		$104.71	$104.71	$125.89