Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $2,753.58 / $6,453.98	Facility		$1,323.35	$2,753.58	$6,453.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,336.58 / $3,209.71	Professional		$1,323.35	$1,336.58	$3,209.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,403.94 / $2,113.79 / $4,738.39	Facility		$1,403.94	$2,113.79	$4,738.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,428.74 / $2,971.77	Professional		$1,323.35	$1,428.74	$2,971.77
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $100.00 / $1,896.69	Facility		$77.40	$100.00	$1,896.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,348.31 / $1,348.31 / $2,952.26	Professional		$1,348.31	$1,348.31	$2,952.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,248.44 / $1,248.44 / $1,323.35	Facility		$1,248.44	$1,248.44	$1,323.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,682.11	Professional		$1,323.35	$1,323.35	$1,682.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,392.52 / $1,531.77 / $1,879.90	Professional		$1,392.52	$1,531.77	$1,879.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,191.02 / $1,588.02 / $2,884.90	Professional		$1,191.02	$1,588.02	$2,884.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,760.30 / $7,015.85 / $7,222.75	Facility		$1,760.30	$7,015.85	$7,222.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,148.12 / $6,148.12 / $6,148.12	Professional		$6,148.12	$6,148.12	$6,148.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $2,854.66 / $2,854.66	Professional		$60.00	$2,854.66	$2,854.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $824.41 / $1,323.35 / $2,088.69	Facility		$824.41	$1,323.35	$2,088.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,796.35	Professional		$1,323.35	$1,323.35	$1,796.35
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,497.64 / $2,497.64 / $2,497.64	Professional		$2,497.64	$2,497.64	$2,497.64
United Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $2,542.16	Professional		$1,323.35	$1,323.35	$2,542.16