Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $626.78 / $626.78 / $3,108.22	Facility		$626.78	$626.78	$3,108.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $468.81 / $626.78 / $3,108.22	Professional		$468.81	$626.78	$3,108.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.29 / $1,720.74 / $3,742.99	Facility		$659.29	$1,720.74	$3,742.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $659.29 / $659.29 / $1,026.47	Professional		$659.29	$659.29	$1,026.47
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,317.93 / $2,353.44	Facility		$97.00	$1,317.93	$2,353.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,429.37 / $3,329.48	Professional		$100.00	$1,429.37	$3,329.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.27 / $616.27 / $855.80	Facility		$616.27	$616.27	$855.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $449.88 / $449.88 / $656.98	Professional		$449.88	$449.88	$656.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $861.82 / $1,077.28 / $1,292.74	Professional		$861.82	$1,077.28	$1,292.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $646.37 / $754.10 / $1,637.47	Professional		$646.37	$754.10	$1,637.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,854.27 / $5,140.93 / $5,140.93	Facility		$1,854.27	$5,140.93	$5,140.93
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,568.19 / $5,568.19 / $8,079.60	Professional		$5,568.19	$5,568.19	$8,079.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,274.74 / $2,274.74 / $2,274.74	Professional		$2,274.74	$2,274.74	$2,274.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $630.33 / $1,077.28 / $1,131.14	Facility		$630.33	$1,077.28	$1,131.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $449.88 / $616.27 / $1,025.36	Professional		$449.88	$616.27	$1,025.36
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,033.32 / $2,033.32 / $2,033.32	Professional		$2,033.32	$2,033.32	$2,033.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $861.82 / $861.82 / $861.82	Professional		$861.82	$861.82	$861.82
United Facility/Professional Professional Modifier Low / Median / High Price $468.21 / $492.02 / $1,042.36	Professional		$468.21	$492.02	$1,042.36