Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.95 / $180.95 / $1,159.01	Facility		$180.95	$180.95	$1,159.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.06 / $180.95 / $1,159.01	Professional		$156.06	$180.95	$1,159.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.41 / $566.08 / $1,275.11	Facility		$137.41	$566.08	$1,275.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.82 / $183.50 / $314.24	Professional		$164.82	$183.50	$314.24
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $475.58 / $849.26	Facility		$97.00	$475.58	$849.26
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $532.98 / $1,241.49	Professional		$100.00	$532.98	$1,241.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.89 / $218.57 / $218.57	Facility		$187.89	$218.57	$218.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $159.56 / $225.13	Professional		$159.56	$159.56	$225.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $147.94 / $177.54 / $441.87	Professional		$147.94	$177.54	$441.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $241.02 / $281.19 / $622.64	Professional		$241.02	$281.19	$622.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $668.82 / $1,908.08 / $1,908.08	Facility		$668.82	$1,908.08	$1,908.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,114.42 / $2,165.17 / $2,810.78	Professional		$2,114.42	$2,165.17	$2,810.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $695.81 / $695.81 / $695.81	Professional		$695.81	$695.81	$695.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.03 / $339.42 / $407.54	Facility		$97.03	$339.42	$407.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $159.56 / $218.57 / $362.71	Professional		$159.56	$218.57	$362.71
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $758.20 / $758.20 / $758.20	Professional		$758.20	$758.20	$758.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.94 / $251.52 / $321.36	Professional		$147.94	$251.52	$321.36
United Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $150.31 / $390.96	Professional		$136.47	$150.31	$390.96