Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $6,165.95	Facility		$758.58	$758.58	$6,165.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $776.25 / $3,981.07	Professional		$602.56	$776.25	$3,981.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $724.44 / $3,162.28	Facility		$575.44	$724.44	$3,162.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $794.33 / $1,737.80	Professional		$776.25	$794.33	$1,737.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,454.71 / $3,311.31	Facility		$100.00	$2,454.71	$3,311.31
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,691.53 / $4,570.88	Professional		$1,380.38	$2,691.53	$4,570.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,023.29	Professional		$741.31	$741.31	$1,023.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $1,737.80	Professional		$758.58	$954.99	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,318.26 / $2,290.87	Professional		$870.96	$1,318.26	$2,290.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,760.83 / $6,760.83 / $6,760.83	Facility		$6,760.83	$6,760.83	$6,760.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,244.36 / $9,549.93 / $9,549.93	Professional		$7,244.36	$9,549.93	$9,549.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Professional		$1,479.11	$1,479.11	$1,479.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,445.44 / $1,819.70	Facility		$407.38	$1,445.44	$1,819.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,288.25	Professional		$741.31	$741.31	$1,288.25
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Professional		$2,691.53	$2,691.53	$2,691.53
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,148.15 / $1,318.26	Professional		$758.58	$1,148.15	$1,318.26
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $630.96 / $1,737.80	Facility		$104.71	$630.96	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $707.95 / $1,445.44	Professional		$588.84	$707.95	$1,445.44