Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,608.16 / $5,138.66 / $12,720.00	Facility		$2,608.16	$5,138.66	$12,720.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,634.24 / $5,397.93	Professional		$2,608.16	$2,634.24	$5,397.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,753.41 / $4,166.01 / $9,338.78	Facility		$2,753.41	$4,166.01	$9,338.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,543.89 / $2,639.89 / $4,991.79	Professional		$2,543.89	$2,639.89	$4,991.79
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $100.00 / $3,541.54	Facility		$77.40	$100.00	$3,541.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $2,657.37 / $2,657.37 / $5,721.05	Professional		$2,657.37	$2,657.37	$5,721.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,460.53 / $2,460.53 / $2,608.16	Facility		$2,460.53	$2,460.53	$2,608.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $3,321.71	Professional		$2,608.16	$2,608.16	$3,321.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,732.53 / $3,005.78 / $3,688.92	Professional		$2,732.53	$3,005.78	$3,688.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,347.34 / $3,129.79 / $4,694.68	Professional		$2,347.34	$3,129.79	$4,694.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,469.35 / $13,040.80 / $13,367.15	Facility		$3,469.35	$13,040.80	$13,367.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $12,064.38 / $12,064.38 / $12,064.38	Professional		$12,064.38	$12,064.38	$12,064.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $5,601.68 / $5,601.68	Professional		$60.00	$5,601.68	$5,601.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,924.02 / $2,608.16 / $4,177.13	Facility		$1,924.02	$2,608.16	$4,177.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $3,415.66	Professional		$2,608.16	$2,608.16	$3,415.66
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,667.29 / $3,667.29 / $3,667.29	Professional		$3,667.29	$3,667.29	$3,667.29
United Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $4,656.17	Professional		$2,608.16	$2,608.16	$4,656.17