Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $474.60 / $474.60 / $2,279.96	Facility		$474.60	$474.60	$2,279.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.50 / $474.60 / $2,279.96	Professional		$353.50	$474.60	$2,279.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $360.40 / $1,211.39 / $2,508.36	Facility		$360.40	$1,211.39	$2,508.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.19 / $482.76 / $818.98	Professional		$441.19	$482.76	$818.98
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $935.53 / $1,670.60	Facility		$97.00	$935.53	$1,670.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,048.47 / $2,442.25	Professional		$100.00	$1,048.47	$2,442.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $369.60 / $589.44 / $589.44	Facility		$369.60	$589.44	$589.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.29 / $430.29 / $628.37	Professional		$430.29	$430.29	$628.37
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $220.79 / $264.95 / $869.23	Professional		$220.79	$264.95	$869.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $474.13 / $553.15 / $1,201.11	Professional		$474.13	$553.15	$1,201.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,787.66 / $4,214.43 / $4,214.43	Facility		$1,787.66	$4,214.43	$4,214.43
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,246.98 / $5,246.98 / $6,586.50	Professional		$5,246.98	$5,246.98	$6,586.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,908.81 / $1,908.81 / $1,908.81	Professional		$1,908.81	$1,908.81	$1,908.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $254.51 / $698.61 / $829.72	Facility		$254.51	$698.61	$829.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $430.29 / $589.44 / $752.13	Professional		$430.29	$589.44	$752.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,491.50 / $1,491.50 / $1,491.50	Professional		$1,491.50	$1,491.50	$1,491.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $220.79 / $375.34 / $632.16	Professional		$220.79	$375.34	$632.16
United Facility/Professional Professional Modifier Low / Median / High Price $364.49 / $401.14 / $790.21	Professional		$364.49	$401.14	$790.21