Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $1,288.25	Facility		$162.18	$162.18	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $1,148.15	Professional		$128.82	$162.18	$1,148.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $158.49 / $676.08	Facility		$123.03	$158.49	$676.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $371.54	Professional		$165.96	$165.96	$371.54
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $524.81 / $691.83	Facility		$100.00	$524.81	$691.83
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $562.34 / $954.99	Professional		$288.40	$562.34	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $169.82 / $169.82	Facility		$138.04	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $169.82	Professional		$144.54	$144.54	$169.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $363.08	Professional		$158.49	$199.53	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $501.19	Professional		$181.97	$275.42	$501.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,238.72 / $2,238.72	Professional		$1,548.82	$2,238.72	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $275.42 / $380.19	Facility		$91.20	$275.42	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $288.40	Professional		$144.54	$144.54	$288.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $239.88 / $275.42	Professional		$158.49	$239.88	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $177.83 / $371.54	Facility		$22.39	$177.83	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $302.00	Professional		$128.82	$162.18	$302.00