Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $4,897.79	Facility		$501.19	$501.19	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $501.19 / $4,265.80	Professional		$389.05	$501.19	$4,265.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $489.78 / $2,187.76	Facility		$380.19	$489.78	$2,187.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $524.81 / $1,230.27	Professional		$501.19	$524.81	$1,230.27
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,949.84 / $2,630.27	Facility		$100.00	$1,949.84	$2,630.27
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $2,089.30 / $3,630.78	Professional		$1,096.48	$2,089.30	$3,630.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $562.34	Facility		$524.81	$524.81	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $524.81	Professional		$380.19	$380.19	$524.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $549.54 / $1,380.38	Professional		$436.52	$549.54	$1,380.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,023.29 / $1,819.70	Professional		$691.83	$1,023.29	$1,819.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Facility		$5,370.32	$5,370.32	$5,370.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,495.41 / $8,317.64 / $8,317.64	Professional		$5,495.41	$8,317.64	$8,317.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Professional		$851.14	$851.14	$851.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $954.99 / $1,380.38	Facility		$346.74	$954.99	$1,380.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $1,071.52	Professional		$380.19	$380.19	$1,071.52
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Professional		$2,089.30	$2,089.30	$2,089.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $1,023.29	Professional		$436.52	$660.69	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $416.87 / $1,148.15	Facility		$69.18	$416.87	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $478.63 / $1,122.02	Professional		$389.05	$478.63	$1,122.02