Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.55 / $167.55 / $1,073.20	Facility		$167.55	$167.55	$1,073.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.08 / $167.55 / $1,073.20	Professional		$138.08	$167.55	$1,073.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.24 / $524.16 / $1,180.71	Facility		$127.24	$524.16	$1,180.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $169.99 / $259.44	Professional		$136.00	$169.99	$259.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $440.36 / $786.36	Facility		$97.00	$440.36	$786.36
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $493.53 / $1,149.60	Professional		$100.00	$493.53	$1,149.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.07 / $174.32 / $198.82	Facility		$172.07	$174.32	$198.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $127.25 / $185.83	Professional		$127.25	$127.25	$185.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $116.70 / $140.04 / $409.16	Professional		$116.70	$140.04	$409.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.18 / $260.37 / $576.54	Professional		$223.18	$260.37	$576.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $566.30 / $1,530.87 / $1,766.81	Facility		$566.30	$1,530.87	$1,766.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,853.10 / $1,897.56 / $2,548.05	Professional		$1,853.10	$1,897.56	$2,548.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $676.25 / $676.25 / $676.25	Professional		$676.25	$676.25	$676.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.85 / $318.83 / $371.96	Facility		$89.85	$318.83	$371.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.25 / $174.32 / $287.77	Professional		$127.25	$174.32	$287.77
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $702.06 / $702.06 / $702.06	Professional		$702.06	$702.06	$702.06
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $116.70 / $198.39 / $297.57	Professional		$116.70	$198.39	$297.57
United Facility/Professional Professional Modifier Low / Median / High Price $126.37 / $139.18 / $353.01	Professional		$126.37	$139.18	$353.01