Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $7,413.10	Facility		$891.25	$891.25	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $891.25 / $6,606.93	Professional		$707.95	$891.25	$6,606.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $851.14 / $3,715.35	Facility		$676.08	$851.14	$3,715.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,995.26	Professional		$912.01	$912.01	$1,995.26
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,090.30 / $3,981.07	Facility		$100.00	$3,090.30	$3,981.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $3,235.94 / $5,495.41	Professional		$1,659.59	$3,235.94	$5,495.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $933.25 / $933.25	Facility		$794.33	$933.25	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $933.25	Professional		$794.33	$794.33	$933.25
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,905.46 / $2,344.23	Professional		$1,412.54	$1,905.46	$2,344.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,584.89 / $2,818.38	Professional		$1,047.13	$1,584.89	$2,818.38
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,128.31 / $8,128.31 / $8,128.31	Facility		$8,128.31	$8,128.31	$8,128.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,709.64 / $13,489.63 / $13,489.63	Professional		$8,709.64	$13,489.63	$13,489.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Professional		$1,621.81	$1,621.81	$1,621.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,548.82 / $2,187.76	Facility		$501.19	$1,548.82	$2,187.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $1,584.89	Professional		$794.33	$794.33	$1,584.89
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $3,235.94	Professional		$3,235.94	$3,235.94	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $588.84 / $1,071.52	Facility		$48.98	$588.84	$1,071.52
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $891.25 / $1,737.80	Professional		$691.83	$891.25	$1,737.80