Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,222.50 / $2,222.50 / $13,059.90	Facility		$2,222.50	$2,222.50	$13,059.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,620.12 / $2,222.50 / $13,059.90	Professional		$1,620.12	$2,222.50	$13,059.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,687.72 / $6,533.48 / $14,368.31	Facility		$1,687.72	$6,533.48	$14,368.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,150.96 / $2,260.71 / $3,992.76	Professional		$2,150.96	$2,260.71	$3,992.76
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $5,358.89 / $9,569.45	Facility		$97.00	$5,358.89	$9,569.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $6,005.83 / $13,989.57	Professional		$100.00	$6,005.83	$13,989.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,117.11 / $2,717.61 / $2,717.61	Facility		$2,117.11	$2,717.61	$2,717.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,983.86 / $1,983.86 / $2,799.14	Professional		$1,983.86	$1,983.86	$2,799.14
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,209.58 / $2,651.50 / $4,979.10	Professional		$2,209.58	$2,651.50	$4,979.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,715.87 / $3,168.52 / $6,880.20	Professional		$2,715.87	$3,168.52	$6,880.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,715.37 / $21,500.64 / $21,500.64	Facility		$8,715.37	$21,500.64	$21,500.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $24,570.97 / $24,570.97 / $27,929.93	Professional		$24,570.97	$24,570.97	$27,929.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $7,585.92 / $7,585.92 / $7,585.92	Professional		$7,585.92	$7,585.92	$7,585.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,191.82 / $3,847.48 / $4,526.45	Facility		$1,191.82	$3,847.48	$4,526.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,983.86 / $2,717.61 / $4,014.96	Professional		$1,983.86	$2,717.61	$4,014.96
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $8,543.48 / $8,543.48 / $8,543.48	Professional		$8,543.48	$8,543.48	$8,543.48
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,209.58 / $3,621.16 / $3,621.16	Professional		$2,209.58	$3,621.16	$3,621.16
United Facility/Professional Professional Modifier Low / Median / High Price $1,756.75 / $2,168.23 / $4,526.45	Professional		$1,756.75	$2,168.23	$4,526.45