Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $933.25	Facility		$125.89	$125.89	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $812.83	Professional		$93.33	$131.83	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $123.03 / $501.19	Facility		$97.72	$123.03	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $269.15	Professional		$128.82	$128.82	$269.15
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $371.54 / $501.19	Facility		$100.00	$371.54	$501.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $398.11 / $691.83	Professional		$204.17	$398.11	$691.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $151.36 / $151.36	Facility		$100.00	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $151.36	Professional		$109.65	$109.65	$151.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $263.03	Professional		$107.15	$131.83	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $354.81	Professional		$138.04	$194.98	$354.81
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 $1,412.54 / $1,584.89 / $1,584.89	Professional		$1,412.54	$1,584.89	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $213.80 / $295.12	Facility		$72.44	$213.80	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $269.15	Professional		$109.65	$109.65	$269.15
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $158.49 / $194.98	Professional		$107.15	$158.49	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $104.71 / $288.40	Facility		$17.38	$104.71	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $107.15 / $218.78	Professional		$97.72	$107.15	$218.78