Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $1,000.00	Facility		$114.82	$114.82	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $870.96	Professional		$89.13	$114.82	$870.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $112.20 / $478.63	Facility		$87.10	$112.20	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $263.03	Professional		$117.49	$117.49	$263.03
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $398.11 / $537.03	Facility		$100.00	$398.11	$537.03
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $436.52 / $741.31	Professional		$223.87	$436.52	$741.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $123.03 / $123.03	Facility		$107.15	$123.03	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $123.03	Professional		$91.20	$91.20	$123.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $281.84	Professional		$89.13	$112.20	$281.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $389.05	Professional		$141.25	$208.93	$389.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $1,778.28	Professional		$1,288.25	$1,778.28	$1,778.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $204.17 / $281.84	Facility		$77.62	$204.17	$281.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $194.98	Professional		$91.20	$91.20	$194.98
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $208.93	Professional		$89.13	$134.90	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $95.50 / $263.03	Facility		$15.85	$95.50	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $102.33 / $234.42	Professional		$89.13	$102.33	$234.42