Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $165.84 / $421.79	Facility		$81.90	$165.84	$421.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $82.72 / $174.68	Professional		$81.90	$82.72	$174.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.89 / $130.82 / $293.25	Facility		$86.89	$130.82	$293.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $85.99 / $187.60	Professional		$81.90	$85.99	$187.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $88.73 / $101.15	Facility		$76.20	$88.73	$101.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $83.45 / $87.62 / $195.73	Professional		$83.45	$87.62	$195.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.26 / $77.26 / $81.90	Facility		$77.26	$77.26	$81.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $100.44	Professional		$81.90	$81.90	$100.44
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $78.86 / $79.34 / $107.12	Professional		$78.86	$79.34	$107.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $98.28 / $164.00	Professional		$73.70	$98.28	$164.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.90 / $394.30 / $409.50	Facility		$104.90	$394.30	$409.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $350.34 / $350.34 / $350.34	Professional		$350.34	$350.34	$350.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.66 / $162.66 / $162.66	Professional		$162.66	$162.66	$162.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.90 / $85.18 / $139.36	Facility		$81.90	$85.18	$139.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $101.94	Professional		$81.90	$81.90	$101.94
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $118.67 / $118.67 / $118.67	Professional		$118.67	$118.67	$118.67
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $65.52 / $81.90 / $122.85	Professional		$65.52	$81.90	$122.85
United Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $81.90 / $157.33	Professional		$81.90	$81.90	$157.33