Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.25 / $328.50 / $1,648.24	Facility		$164.25	$328.50	$1,648.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $165.90 / $310.70	Professional		$164.25	$165.90	$310.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.25 / $262.36 / $643.60	Facility		$174.25	$262.36	$643.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.21 / $169.37 / $333.46	Professional		$163.21	$169.37	$333.46
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $100.00 / $196.86	Facility		$77.40	$100.00	$196.86
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $167.35 / $167.35 / $372.31	Professional		$167.35	$167.35	$372.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.96 / $154.96 / $164.25	Facility		$154.96	$154.96	$164.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $190.52	Professional		$164.25	$164.25	$190.52
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $152.28 / $152.51 / $205.88	Professional		$152.28	$152.51	$205.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.83 / $197.10 / $361.35	Professional		$147.83	$197.10	$361.35
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $202.56 / $761.40 / $821.25	Facility		$202.56	$761.40	$821.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,623.57 / $3,623.57 / $3,623.57	Professional		$3,623.57	$3,623.57	$3,623.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $312.64 / $312.64	Professional		$60.00	$312.64	$312.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $164.25 / $169.18 / $272.72	Facility		$164.25	$169.18	$272.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $190.64	Professional		$164.25	$164.25	$190.64
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $211.08 / $211.08 / $211.08	Professional		$211.08	$211.08	$211.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $131.40 / $164.25 / $246.38	Professional		$131.40	$164.25	$246.38
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $165.89 / $295.64	Professional		$164.25	$165.89	$295.64