Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $4,073.80	Facility		$562.34	$562.34	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $562.34 / $3,548.13	Professional		$416.87	$562.34	$3,548.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $891.25 / $954.99	Professional		$660.69	$891.25	$954.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $537.03 / $2,238.72	Facility		$426.58	$537.03	$2,238.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $588.84 / $1,230.27	Professional		$562.34	$588.84	$1,230.27
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,621.81 / $2,187.76	Facility		$100.00	$1,621.81	$2,187.76
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,737.80 / $3,019.95	Professional		$912.01	$1,737.80	$3,019.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $588.84 / $588.84	Facility		$436.52	$588.84	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $588.84	Professional		$426.58	$426.58	$588.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $562.34 / $1,148.15	Professional		$457.09	$562.34	$1,148.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $851.14 / $1,548.82	Professional		$575.44	$851.14	$1,548.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility		$4,786.30	$4,786.30	$4,786.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $7,943.28 / $7,943.28	Professional		$6,165.95	$7,943.28	$7,943.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Professional		$1,258.93	$1,258.93	$1,258.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $933.25 / $1,258.93	Facility		$316.23	$933.25	$1,258.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $1,023.29	Professional		$426.58	$426.58	$1,023.29
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Professional		$1,778.28	$1,778.28	$1,778.28
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $676.08 / $851.14	Professional		$457.09	$676.08	$851.14
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $616.60 / $1,258.93	Facility		$77.62	$616.60	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $954.99	Professional		$426.58	$562.34	$954.99