Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $207.91 / $612.50	Facility		$95.90	$207.91	$612.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $96.86 / $289.29	Professional		$95.90	$96.86	$289.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.74 / $153.18 / $343.38	Facility		$101.74	$153.18	$343.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $112.11 / $456.07	Professional		$95.90	$112.11	$456.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $100.00 / $509.76	Facility		$77.40	$100.00	$509.76
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $97.71 / $100.00 / $294.20	Professional		$97.71	$100.00	$294.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.47 / $90.47 / $95.90	Facility		$90.47	$90.47	$95.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $169.69	Professional		$95.90	$95.90	$169.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $133.69 / $157.10 / $188.52	Professional		$133.69	$157.10	$188.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.31 / $115.08 / $244.55	Professional		$86.31	$115.08	$244.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,971.72 / $2,009.53 / $2,247.46	Facility		$1,971.72	$2,009.53	$2,247.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,879.42 / $5,879.42 / $5,879.42	Professional		$5,879.42	$5,879.42	$5,879.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $274.06 / $274.06	Professional		$60.00	$274.06	$274.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $125.58 / $1,937.88	Facility		$95.90	$125.58	$1,937.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $220.31	Professional		$95.90	$95.90	$220.31
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $463.46 / $463.46 / $463.46	Professional		$463.46	$463.46	$463.46
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $76.72 / $95.90 / $143.85	Professional		$76.72	$95.90	$143.85
United Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $98.59 / $194.53	Professional		$95.90	$98.59	$194.53