Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $446.68 / $912.01	Facility		$104.71	$446.68	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $812.83	Professional		$77.62	$109.65	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $102.33 / $436.52	Facility		$79.43	$102.33	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $229.09	Professional		$107.15	$107.15	$229.09
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $363.08 / $489.78	Facility		$100.00	$363.08	$489.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $398.11 / $676.08	Professional		$204.17	$398.11	$676.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $112.20 / $112.20	Facility		$97.72	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $112.20	Professional		$83.18	$83.18	$112.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $257.04	Professional		$79.43	$100.00	$257.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $354.81	Professional		$128.82	$194.98	$354.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,584.89 / $1,584.89	Professional		$1,096.48	$1,584.89	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $190.55 / $257.04	Facility		$67.61	$190.55	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $169.82	Professional		$83.18	$83.18	$169.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $194.98	Professional		$79.43	$120.23	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $114.82 / $239.88	Facility		$14.45	$114.82	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $213.80	Professional		$83.18	$104.71	$213.80