Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $1,047.13	Facility		$107.15	$107.15	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $109.65 / $912.01	Professional		$83.18	$109.65	$912.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $104.71 / $467.74	Facility		$81.28	$104.71	$467.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $263.03	Professional		$109.65	$109.65	$263.03
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $416.87 / $562.34	Facility		$100.00	$416.87	$562.34
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $776.25	Professional		$229.09	$446.68	$776.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $120.23	Facility		$112.20	$112.20	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $295.12	Professional		$117.49	$147.91	$295.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $398.11	Professional		$144.54	$218.78	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $1,380.38	Professional		$1,148.15	$1,380.38	$1,380.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $204.17 / $295.12	Facility		$63.10	$204.17	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $199.53	Professional		$81.28	$81.28	$199.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $218.78	Professional		$117.49	$177.83	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $89.13 / $245.47	Facility		$14.79	$89.13	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $239.88	Professional		$83.18	$107.15	$239.88