Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $138.04 / $1,096.48	Facility		$12.88	$138.04	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $977.24	Professional		$109.65	$138.04	$977.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $134.90 / $575.44	Facility		$104.71	$134.90	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $281.84	Professional		$134.90	$134.90	$281.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $446.68 / $588.84	Facility		$100.00	$446.68	$588.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $478.63 / $812.83	Professional		$245.47	$478.63	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $169.82	Professional		$123.03	$123.03	$169.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $309.03	Professional		$134.90	$169.82	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $234.42 / $416.87	Professional		$154.88	$234.42	$416.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,905.46 / $1,905.46	Professional		$1,318.26	$1,905.46	$1,905.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $234.42 / $323.59	Facility		$77.62	$234.42	$323.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $245.47	Professional		$123.03	$123.03	$245.47
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $234.42	Professional		$134.90	$204.17	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $114.82 / $316.23	Facility		$19.05	$114.82	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $257.04	Professional		$107.15	$125.89	$257.04