Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.28 / $219.28 / $1,404.52	Facility		$219.28	$219.28	$1,404.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.85 / $219.28 / $1,404.52	Professional		$159.85	$219.28	$1,404.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $166.55 / $686.00 / $1,545.25	Facility		$166.55	$686.00	$1,545.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.30 / $220.24 / $378.04	Professional		$198.30	$220.24	$378.04
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $576.33 / $1,029.16	Facility		$97.00	$576.33	$1,029.16
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $645.90 / $1,504.50	Professional		$100.00	$645.90	$1,504.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.68 / $274.64 / $274.64	Facility		$227.68	$274.64	$274.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.49 / $200.49 / $292.80	Professional		$200.49	$200.49	$292.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $227.81 / $273.37 / $535.48	Professional		$227.81	$273.37	$535.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $292.08 / $340.76 / $739.94	Professional		$292.08	$340.76	$739.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $825.17 / $1,955.07 / $2,312.30	Facility		$825.17	$1,955.07	$2,312.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,695.59 / $2,760.30 / $3,209.93	Professional		$2,695.59	$2,760.30	$3,209.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $748.45 / $748.45 / $748.45	Professional		$748.45	$748.45	$748.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $117.59 / $406.58 / $493.87	Facility		$117.59	$406.58	$493.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $200.49 / $274.64 / $413.39	Professional		$200.49	$274.64	$413.39
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $918.80 / $918.80 / $918.80	Professional		$918.80	$918.80	$918.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $227.81 / $387.28 / $389.44	Professional		$227.81	$387.28	$389.44
United Facility/Professional Professional Modifier Low / Median / High Price $171.45 / $213.52 / $491.14	Professional		$171.45	$213.52	$491.14