Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.64 / $112.64 / $591.32	Facility		$112.64	$112.64	$591.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.72 / $112.64 / $572.26	Professional		$96.72	$112.64	$572.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.54 / $310.89 / $650.54	Facility		$85.54	$310.89	$650.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.41 / $114.05 / $195.22	Professional		$102.41	$114.05	$195.22
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $242.61 / $433.23	Facility		$97.00	$242.61	$433.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $271.93 / $633.41	Professional		$100.00	$271.93	$633.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $162.80	Facility		$140.54	$140.54	$162.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $102.59 / $140.54	Professional		$102.59	$102.59	$140.54
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $163.95 / $204.94 / $245.93	Professional		$163.95	$204.94	$245.93
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $350.34 / $350.34 / $350.34	Professional		$350.34	$350.34	$350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.96 / $143.46 / $317.66	Professional		$122.96	$143.46	$317.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $352.65 / $977.65 / $977.65	Facility		$352.65	$977.65	$977.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,056.91 / $1,056.91 / $1,537.05	Professional		$1,056.91	$1,056.91	$1,537.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $432.67 / $432.67 / $432.67	Professional		$432.67	$432.67	$432.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.40 / $185.20 / $215.19	Facility		$60.40	$185.20	$215.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.59 / $102.59 / $200.14	Professional		$102.59	$102.59	$200.14
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $386.83 / $386.83 / $386.83	Professional		$386.83	$386.83	$386.83
United Facility/Professional Professional Modifier Low / Median / High Price $84.96 / $93.57 / $197.64	Professional		$84.96	$93.57	$197.64