Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $234.42	Facility		$109.65	$109.65	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $93.33 / $234.42	Professional		$63.10	$93.33	$234.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $158.49 / $398.11	Facility		$125.89	$158.49	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $154.88	Professional		$93.33	$112.20	$154.88
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $338.84 / $446.68	Facility		$97.72	$338.84	$446.68
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $190.55 / $251.19	Professional		$102.33	$190.55	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $128.82	Professional		$93.33	$93.33	$128.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $120.23 / $144.54	Professional		$54.95	$120.23	$144.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $144.54 / $263.03	Professional		$38.90	$144.54	$263.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Professional		$812.83	$812.83	$812.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $61.66 / $154.88	Facility		$38.90	$61.66	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $128.82	Professional		$85.11	$93.33	$128.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $131.83 / $204.17	Professional		$44.67	$131.83	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $87.10 / $194.98	Facility		$14.45	$87.10	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $165.96	Professional		$57.54	$91.20	$165.96