Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,162.28 / $14,454.40	Facility		$1,819.70	$3,162.28	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,819.70 / $12,882.50	Professional		$1,479.11	$1,819.70	$12,882.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,778.28 / $7,585.78	Facility		$1,412.54	$1,778.28	$7,585.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $3,715.35	Professional		$1,819.70	$1,819.70	$3,715.35
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $5,888.44 / $7,762.47	Facility		$100.00	$5,888.44	$7,762.47
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $6,309.57 / $10,715.19	Professional		$3,235.94	$6,309.57	$10,715.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,238.72 / $2,238.72	Facility		$1,548.82	$2,238.72	$2,238.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $2,238.72	Professional		$1,621.81	$1,621.81	$2,238.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,621.81 / $4,073.80	Professional		$1,288.25	$1,621.81	$4,073.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,090.30 / $5,370.32	Professional		$2,041.74	$3,090.30	$5,370.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $15,848.93 / $15,848.93 / $15,848.93	Facility		$15,848.93	$15,848.93	$15,848.93
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $17,378.01 / $25,118.86 / $25,118.86	Professional		$17,378.01	$25,118.86	$25,118.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Professional		$3,467.37	$3,467.37	$3,467.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $3,090.30 / $4,265.80	Facility		$1,071.52	$3,090.30	$4,265.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $3,235.94	Professional		$1,621.81	$1,621.81	$3,235.94
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $6,309.57 / $6,309.57 / $6,309.57	Professional		$6,309.57	$6,309.57	$6,309.57
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $3,090.30	Professional		$1,288.25	$1,949.84	$3,090.30
United Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $2,041.74 / $4,168.69	Facility		$251.19	$2,041.74	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,819.70 / $3,388.44	Professional		$1,445.44	$1,819.70	$3,388.44