Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $196.55 / $466.53	Facility		$89.34	$196.55	$466.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $92.02 / $249.44	Professional		$89.34	$92.02	$249.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.02 / $142.69 / $319.89	Facility		$95.02	$142.69	$319.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $108.53 / $236.79	Professional		$89.34	$108.53	$236.79
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.70 / $100.00 / $169.56	Facility		$77.70	$100.00	$169.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $91.03 / $95.58 / $237.68	Professional		$91.03	$95.58	$237.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.29 / $84.29 / $89.34	Facility		$84.29	$84.29	$89.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $128.22	Professional		$89.34	$89.34	$128.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $118.75 / $133.32 / $179.98	Professional		$118.75	$133.32	$179.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.41 / $107.21 / $202.46	Professional		$80.41	$107.21	$202.46
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $131.07 / $437.77 / $593.75	Facility		$131.07	$437.77	$593.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,160.52 / $1,160.52 / $1,160.52	Professional		$1,160.52	$1,160.52	$1,160.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $273.30 / $273.30	Professional		$60.00	$273.30	$273.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $93.81 / $158.35	Facility		$89.34	$93.81	$158.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $166.65	Professional		$89.34	$89.34	$166.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $209.44 / $209.44 / $209.44	Professional		$209.44	$209.44	$209.44
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $89.34 / $134.02	Professional		$71.48	$89.34	$134.02
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $172.00	Professional		$89.34	$89.34	$172.00