Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $7,943.28	Facility		$831.76	$831.76	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $831.76 / $7,079.46	Professional		$660.69	$831.76	$7,079.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $794.33 / $3,630.78	Facility		$630.96	$794.33	$3,630.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $1,995.26	Professional		$812.83	$812.83	$1,995.26
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,162.28 / $4,265.80	Facility		$100.00	$3,162.28	$4,265.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $3,467.37 / $5,888.44	Professional		$1,778.28	$3,467.37	$5,888.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $912.01	Facility		$851.14	$851.14	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $851.14	Professional		$630.96	$630.96	$851.14
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $977.24 / $2,238.72	Professional		$776.25	$977.24	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,698.24 / $2,951.21	Professional		$1,122.02	$1,698.24	$2,951.21
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,709.64 / $8,709.64 / $8,709.64	Facility		$8,709.64	$8,709.64	$8,709.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $13,182.57 / $13,182.57 / $13,182.57	Professional		$13,182.57	$13,182.57	$13,182.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,584.89 / $2,238.72	Facility		$467.74	$1,584.89	$2,238.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $1,737.80	Professional		$630.96	$630.96	$1,737.80
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Professional		$3,467.37	$3,467.37	$3,467.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $1,698.24	Professional		$776.25	$1,174.90	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $676.08 / $1,862.09	Facility		$112.20	$676.08	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,862.09	Professional		$630.96	$794.33	$1,862.09