Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $654.41 / $654.41 / $4,191.72	Facility		$654.41	$654.41	$4,191.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $573.20 / $654.41 / $4,191.72	Professional		$573.20	$654.41	$4,191.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $496.95 / $2,047.31 / $4,611.68	Facility		$496.95	$2,047.31	$4,611.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $663.62 / $663.62 / $1,291.28	Professional		$663.62	$663.62	$1,291.28
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,720.00 / $3,071.42	Facility		$97.00	$1,720.00	$3,071.42
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,927.65 / $4,490.14	Professional		$100.00	$1,927.65	$4,490.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $679.04 / $680.86 / $776.58	Facility		$679.04	$680.86	$776.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $497.03 / $701.29	Professional		$497.03	$497.03	$701.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $644.00 / $772.80 / $1,598.10	Professional		$644.00	$772.80	$1,598.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $871.69 / $1,016.97 / $2,208.29	Professional		$871.69	$1,016.97	$2,208.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,818.59 / $6,900.90 / $6,900.90	Facility		$2,818.59	$6,900.90	$6,900.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,973.54 / $6,973.54 / $10,896.15	Professional		$6,973.54	$6,973.54	$10,896.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,628.65 / $2,628.65 / $2,628.65	Professional		$2,628.65	$2,628.65	$2,628.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $350.94 / $1,234.90 / $1,452.82	Facility		$350.94	$1,234.90	$1,452.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $497.03 / $680.86 / $1,112.75	Professional		$497.03	$680.86	$1,112.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,742.13 / $2,742.13 / $2,742.13	Professional		$2,742.13	$2,742.13	$2,742.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $644.00 / $1,094.80 / $1,162.26	Professional		$644.00	$1,094.80	$1,162.26
United Facility/Professional Facility Modifier Low / Median / High Price $341.71 / $491.31 / $538.75	Facility		$341.71	$491.31	$538.75
United Facility/Professional Professional Modifier Low / Median / High Price $493.58 / $543.59 / $1,405.74	Professional		$493.58	$543.59	$1,405.74