Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $5,396.10 / $13,895.00	Facility		$2,698.05	$5,396.10	$13,895.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,725.03 / $6,134.73	Professional		$2,698.05	$2,725.03	$6,134.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,862.36 / $4,309.60 / $9,660.64	Facility		$2,862.36	$4,309.60	$9,660.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,799.86 / $5,930.62	Professional		$2,698.05	$2,799.86	$5,930.62
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $3,054.40	Facility		$77.09	$100.00	$3,054.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $2,748.96 / $2,748.96 / $6,608.62	Professional		$2,748.96	$2,748.96	$6,608.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,545.33 / $2,545.33 / $2,698.05	Facility		$2,545.33	$2,545.33	$2,698.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,188.79	Professional		$2,698.05	$2,698.05	$3,188.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,658.13 / $2,923.94 / $3,588.47	Professional		$2,658.13	$2,923.94	$3,588.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,428.25 / $3,237.66 / $5,935.71	Professional		$2,428.25	$3,237.66	$5,935.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,535.81 / $13,220.45 / $13,490.25	Facility		$3,535.81	$13,220.45	$13,490.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,735.90 / $11,735.90 / $11,735.90	Professional		$11,735.90	$11,735.90	$11,735.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,449.16 / $5,449.16 / $5,449.16	Professional		$5,449.16	$5,449.16	$5,449.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $2,805.98 / $4,594.18	Facility		$2,698.05	$2,805.98	$4,594.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,322.66	Professional		$2,698.05	$2,698.05	$3,322.66
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,167.85 / $4,167.85 / $4,167.85	Professional		$4,167.85	$4,167.85	$4,167.85
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,158.44 / $2,698.05 / $4,047.08	Professional		$2,158.44	$2,698.05	$4,047.08
United Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $4,521.39	Professional		$2,698.05	$2,698.05	$4,521.39