Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.38 / $210.38 / $1,347.47	Facility		$210.38	$210.38	$1,347.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.13 / $210.38 / $1,347.47	Professional		$175.13	$210.38	$1,347.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.76 / $658.12 / $1,482.46	Facility		$159.76	$658.12	$1,482.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.35 / $218.27 / $349.61	Professional		$188.35	$218.27	$349.61
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $552.91 / $987.36	Facility		$98.20	$552.91	$987.36
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $619.66 / $1,443.41	Professional		$100.00	$619.66	$1,443.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.44 / $243.19 / $249.64	Facility		$218.44	$243.19	$249.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.53 / $177.53 / $259.25	Professional		$177.53	$177.53	$259.25
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $178.44 / $214.13 / $513.72	Professional		$178.44	$214.13	$513.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $280.20 / $326.91 / $709.87	Professional		$280.20	$326.91	$709.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $763.12 / $1,857.26 / $2,218.35	Facility		$763.12	$1,857.26	$2,218.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,627.87 / $2,690.96 / $2,690.96	Professional		$2,627.87	$2,690.96	$2,690.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $837.40 / $837.40 / $837.40	Professional		$837.40	$837.40	$837.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.81 / $404.20 / $473.81	Facility		$112.81	$404.20	$473.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.53 / $243.19 / $404.20	Professional		$177.53	$243.19	$404.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $881.48 / $881.48 / $881.48	Professional		$881.48	$881.48	$881.48
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $178.44 / $303.35 / $373.62	Professional		$178.44	$303.35	$373.62
United Facility/Professional Professional Modifier Low / Median / High Price $167.45 / $210.58 / $654.91	Professional		$167.45	$210.58	$654.91