Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $1,259.71	Facility		$240.00	$240.00	$1,259.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.76 / $240.00 / $1,259.71	Professional		$190.76	$240.00	$1,259.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.25 / $662.39 / $1,385.90	Facility		$182.25	$662.39	$1,385.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.10 / $243.00 / $416.01	Professional		$224.10	$243.00	$416.01
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $516.89 / $923.01	Facility		$97.00	$516.89	$923.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $579.29 / $1,349.40	Professional		$100.00	$579.29	$1,349.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $318.35 / $318.35 / $346.84	Facility		$318.35	$318.35	$346.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.40 / $232.40 / $339.37	Professional		$232.40	$232.40	$339.37
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $233.38 / $280.06 / $480.26	Professional		$233.38	$280.06	$480.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $261.95 / $305.62 / $663.63	Professional		$261.95	$305.62	$663.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $751.50 / $2,083.02 / $2,083.02	Facility		$751.50	$2,083.02	$2,083.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,252.01 / $2,252.01 / $3,274.50	Professional		$2,252.01	$2,252.01	$3,274.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $921.86 / $921.86 / $921.86	Professional		$921.86	$921.86	$921.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $393.72 / $449.69	Facility		$128.69	$393.72	$449.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $232.40 / $318.35 / $415.57	Professional		$232.40	$318.35	$415.57
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $824.07 / $824.07 / $824.07	Professional		$824.07	$824.07	$824.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $233.38 / $349.28 / $350.07	Professional		$233.38	$349.28	$350.07
United Facility/Professional Professional Modifier Low / Median / High Price $189.70 / $224.35 / $596.74	Professional		$189.70	$224.35	$596.74