Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $8,511.38	Facility		$933.25	$933.25	$8,511.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $933.25 / $7,585.78	Professional		$660.69	$933.25	$7,585.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $891.25 / $3,981.07	Facility		$707.95	$891.25	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $2,187.76	Professional		$933.25	$933.25	$2,187.76
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,467.37 / $4,677.35	Facility		$100.00	$3,467.37	$4,677.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $3,715.35 / $6,309.57	Professional		$1,905.46	$3,715.35	$6,309.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,258.93	Professional		$912.01	$912.01	$1,258.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,380.38 / $2,398.83	Professional		$1,096.48	$1,380.38	$2,398.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,819.70 / $3,162.28	Professional		$1,174.90	$1,819.70	$3,162.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Facility		$9,332.54	$9,332.54	$9,332.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,549.93 / $12,302.69 / $12,302.69	Professional		$9,549.93	$12,302.69	$12,302.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,737.80 / $2,454.71	Facility		$501.19	$1,737.80	$2,454.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,659.59	Professional		$912.01	$912.01	$1,659.59
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $3,715.35	Professional		$3,715.35	$3,715.35	$3,715.35
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,621.81 / $1,862.09	Professional		$1,096.48	$1,621.81	$1,862.09
United Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $1,023.29 / $2,089.30	Facility		$125.89	$1,023.29	$2,089.30
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $933.25 / $1,995.26	Professional		$724.44	$933.25	$1,995.26