Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,296.10 / $2,296.10 / $14,707.00	Facility		$2,296.10	$2,296.10	$14,707.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,673.77 / $2,296.10 / $14,707.00	Professional		$1,673.77	$2,296.10	$14,707.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,743.60 / $7,183.13 / $16,180.39	Facility		$1,743.60	$7,183.13	$16,180.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,335.56 / $2,335.56 / $4,740.50	Professional		$2,335.56	$2,335.56	$4,740.50
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $6,034.75 / $10,776.34	Facility		$97.00	$6,034.75	$10,776.34
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $6,763.27 / $15,753.93	Professional		$100.00	$6,763.27	$15,753.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,384.12 / $3,297.39 / $3,297.39	Facility		$2,384.12	$3,297.39	$3,297.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,407.09 / $2,407.09 / $3,396.31	Professional		$2,407.09	$2,407.09	$3,396.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,540.85 / $3,049.02 / $5,607.04	Professional		$2,540.85	$3,049.02	$5,607.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,058.39 / $3,568.12 / $7,747.91	Professional		$3,058.39	$3,568.12	$7,747.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,510.84 / $19,929.31 / $24,212.22	Facility		$9,510.84	$19,929.31	$24,212.22
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $30,066.71 / $30,788.33 / $30,788.33	Professional		$30,066.71	$30,788.33	$30,788.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $7,837.10 / $7,837.10 / $7,837.10	Professional		$7,837.10	$7,837.10	$7,837.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,231.29 / $4,427.64 / $5,166.22	Facility		$1,231.29	$4,427.64	$5,166.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $2,407.09 / $3,297.39 / $4,851.70	Professional		$2,407.09	$3,297.39	$4,851.70
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $9,620.98 / $9,620.98 / $9,620.98	Professional		$9,620.98	$9,620.98	$9,620.98
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,540.85 / $4,077.85 / $4,077.85	Professional		$2,540.85	$4,077.85	$4,077.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,795.28 / $2,188.94 / $4,631.64	Professional		$1,795.28	$2,188.94	$4,631.64