Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $14,454.40	Facility		$1,737.80	$1,737.80	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,737.80 / $12,882.50	Professional		$1,380.38	$1,737.80	$12,882.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,659.59 / $7,244.36	Facility		$1,318.26	$1,659.59	$7,244.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $3,715.35	Professional		$1,737.80	$1,737.80	$3,715.35
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $6,025.60 / $7,762.47	Facility		$100.00	$6,025.60	$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 / $1,819.70 / $1,819.70	Facility		$1,548.82	$1,819.70	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,819.70	Professional		$1,548.82	$1,548.82	$1,819.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,715.35 / $4,570.88	Professional		$2,754.23	$3,715.35	$4,570.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $3,090.30 / $5,495.41	Professional		$2,041.74	$3,090.30	$5,495.41
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 $16,982.44 / $26,915.35 / $26,915.35	Professional		$16,982.44	$26,915.35	$26,915.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Professional		$3,162.28	$3,162.28	$3,162.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $3,019.95 / $4,265.80	Facility		$977.24	$3,019.95	$4,265.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $3,090.30	Professional		$1,548.82	$1,548.82	$3,090.30
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
United Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $1,148.15 / $2,137.96	Facility		$95.50	$1,148.15	$2,137.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,737.80 / $3,388.44	Professional		$1,348.96	$1,737.80	$3,388.44