Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $16,982.44	Facility		$1,778.28	$1,778.28	$16,982.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $15,135.61	Professional		$1,288.25	$1,778.28	$15,135.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,698.24 / $7,762.47	Facility		$1,348.96	$1,698.24	$7,762.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $4,265.80	Professional		$1,778.28	$1,778.28	$4,265.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $6,918.31 / $9,120.11	Facility		$100.00	$6,918.31	$9,120.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $7,413.10 / $12,589.25	Professional		$3,801.89	$7,413.10	$12,589.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $1,949.84	Facility		$1,819.70	$1,905.46	$1,949.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,905.46	Professional		$1,380.38	$1,380.38	$1,905.46
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,071.52 / $4,786.30	Professional		$870.96	$1,071.52	$4,786.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,630.78 / $6,309.57	Professional		$2,398.83	$3,630.78	$6,309.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $18,620.87 / $18,620.87 / $18,620.87	Facility		$18,620.87	$18,620.87	$18,620.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $18,620.87 / $21,877.62 / $21,877.62	Professional		$18,620.87	$21,877.62	$21,877.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Professional		$2,951.21	$2,951.21	$2,951.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $3,162.28 / $4,786.30	Facility		$1,071.52	$3,162.28	$4,786.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $2,884.03	Professional		$1,380.38	$1,380.38	$2,884.03
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $7,413.10 / $7,413.10 / $7,413.10	Professional		$7,413.10	$7,413.10	$7,413.10
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $3,630.78	Professional		$870.96	$1,288.25	$3,630.78
United Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $1,949.84 / $3,981.07	Facility		$239.88	$1,949.84	$3,981.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,778.28 / $3,890.45	Professional		$1,380.38	$1,778.28	$3,890.45