Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $14,125.38	Facility		$1,659.59	$1,659.59	$14,125.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,659.59 / $12,302.69	Professional		$1,258.93	$1,659.59	$12,302.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $6,918.31	Facility		$1,258.93	$1,621.81	$6,918.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $3,548.13	Professional		$1,698.24	$1,698.24	$3,548.13
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $5,623.41 / $7,585.78	Facility		$100.00	$5,623.41	$7,585.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $6,025.60 / $10,471.29	Professional		$3,162.28	$6,025.60	$10,471.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,737.80 / $1,737.80	Facility		$1,513.56	$1,737.80	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,737.80	Professional		$1,258.93	$1,258.93	$1,737.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,288.25 / $3,981.07	Professional		$1,023.29	$1,288.25	$3,981.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,951.21 / $5,248.07	Professional		$1,995.26	$2,951.21	$5,248.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $15,488.17 / $15,488.17 / $15,488.17	Facility		$15,488.17	$15,488.17	$15,488.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $16,982.44 / $22,908.68 / $22,908.68	Professional		$16,982.44	$22,908.68	$22,908.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,884.03 / $4,073.80	Facility		$1,047.13	$2,884.03	$4,073.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $3,162.28	Professional		$1,258.93	$1,258.93	$3,162.28
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $6,025.60 / $6,025.60 / $6,025.60	Professional		$6,025.60	$6,025.60	$6,025.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,548.82 / $2,951.21	Professional		$1,023.29	$1,548.82	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,819.70 / $3,801.89	Facility		$229.09	$1,819.70	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,659.59 / $3,235.94	Professional		$1,318.26	$1,659.59	$3,235.94