Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $808.22 / $808.22 / $5,176.82	Facility		$808.22	$808.22	$5,176.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $601.99 / $808.22 / $5,176.82	Professional		$601.99	$808.22	$5,176.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $613.75 / $2,528.46 / $5,695.49	Facility		$613.75	$2,528.46	$5,695.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $674.19 / $822.12 / $1,251.48	Professional		$674.19	$822.12	$1,251.48
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $2,124.23 / $3,793.27	Facility		$98.20	$2,124.23	$3,793.27
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $2,380.66 / $5,545.37	Professional		$100.00	$2,380.66	$5,545.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $839.21 / $870.50 / $959.10	Facility		$839.21	$870.50	$959.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $635.47 / $896.62	Professional		$635.47	$635.47	$896.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $959.10 / $1,150.92 / $1,973.68	Professional		$959.10	$1,150.92	$1,973.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,076.55 / $1,255.98 / $2,727.26	Professional		$1,076.55	$1,255.98	$2,727.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,731.73 / $7,424.54 / $8,522.69	Facility		$2,731.73	$7,424.54	$8,522.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,101.42 / $10,343.84 / $12,857.48	Professional		$10,101.42	$10,343.84	$12,857.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,758.64 / $2,758.64 / $2,758.64	Professional		$2,758.64	$2,758.64	$2,758.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $433.41 / $1,525.11 / $1,862.06	Facility		$433.41	$1,525.11	$1,862.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $635.47 / $870.50 / $1,481.15	Professional		$635.47	$870.50	$1,481.15
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,386.56 / $3,386.56 / $3,386.56	Professional		$3,386.56	$3,386.56	$3,386.56
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $959.10 / $1,435.40 / $1,438.65	Professional		$959.10	$1,435.40	$1,438.65
United Facility/Professional Professional Modifier Low / Median / High Price $631.94 / $808.22 / $1,794.25	Professional		$631.94	$808.22	$1,794.25