Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $6,309.57	Facility		$812.83	$812.83	$6,309.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $812.83 / $5,623.41	Professional		$630.96	$812.83	$5,623.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $776.25 / $3,311.31	Facility		$616.60	$776.25	$3,311.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $1,819.70	Professional		$794.33	$794.33	$1,819.70
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,570.40 / $3,467.37	Facility		$100.00	$2,570.40	$3,467.37
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,754.23 / $4,677.35	Professional		$1,412.54	$2,754.23	$4,677.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,047.13	Facility		$691.83	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $1,047.13	Professional		$758.58	$758.58	$1,047.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $1,778.28	Professional		$776.25	$977.24	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,348.96 / $2,344.23	Professional		$831.76	$1,348.96	$2,344.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $7,079.46 / $7,079.46 / $7,079.46	Facility		$7,079.46	$7,079.46	$7,079.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,585.78 / $10,964.78 / $10,964.78	Professional		$7,585.78	$10,964.78	$10,964.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $1,348.96 / $1,862.09	Facility		$457.09	$1,348.96	$1,862.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $1,445.44	Professional		$758.58	$758.58	$1,445.44
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Professional		$2,754.23	$2,754.23	$2,754.23
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $1,348.96	Professional		$776.25	$1,174.90	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $660.69 / $1,819.70	Facility		$109.65	$660.69	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $724.44 / $1,479.11	Professional		$616.60	$724.44	$1,479.11