Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $362.75 / $362.75 / $1,956.11	Facility		$362.75	$362.75	$1,956.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.10 / $362.75 / $1,956.11	Professional		$276.10	$362.75	$1,956.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.47 / $1,001.20 / $2,152.11	Facility		$275.47	$1,001.20	$2,152.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.81 / $368.99 / $614.08	Professional		$330.81	$368.99	$614.08
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $802.65 / $1,433.30	Facility		$97.00	$802.65	$1,433.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $899.56 / $2,095.37	Professional		$100.00	$899.56	$2,095.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $317.08 / $427.13 / $427.13	Facility		$317.08	$427.13	$427.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.80 / $311.80 / $439.94	Professional		$311.80	$311.80	$439.94
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $208.92 / $250.70 / $745.78	Professional		$208.92	$250.70	$745.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $406.79 / $474.59 / $1,030.53	Professional		$406.79	$474.59	$1,030.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,207.97 / $3,226.39 / $3,226.39	Facility		$1,207.97	$3,226.39	$3,226.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,986.28 / $3,986.28 / $6,039.83	Professional		$3,986.28	$3,986.28	$6,039.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,650.88 / $1,650.88 / $1,650.88	Professional		$1,650.88	$1,650.88	$1,650.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $194.53 / $588.89 / $711.88	Facility		$194.53	$588.89	$711.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $311.80 / $427.13 / $576.28	Professional		$311.80	$427.13	$576.28
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,279.64 / $1,279.64 / $1,279.64	Professional		$1,279.64	$1,279.64	$1,279.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $208.92 / $355.16 / $542.38	Professional		$208.92	$355.16	$542.38
United Facility/Professional Professional Modifier Low / Median / High Price $283.63 / $335.21 / $677.98	Professional		$283.63	$335.21	$677.98