Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $912.01	Facility		$114.82	$114.82	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $812.83	Professional		$91.20	$114.82	$812.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $162.18 / $501.19	Facility		$128.82	$162.18	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $169.82 / $234.42	Professional		$154.88	$169.82	$234.42
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $371.54 / $489.78	Facility		$100.00	$371.54	$489.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $398.11 / $676.08	Professional		$204.17	$398.11	$676.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$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 $173.78 / $234.42 / $288.40	Professional		$173.78	$234.42	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $380.19	Professional		$147.91	$213.80	$380.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,584.89 / $1,584.89	Professional		$1,096.48	$1,584.89	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $213.80 / $269.15	Facility		$114.82	$213.80	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $204.17	Professional		$144.54	$144.54	$204.17
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Professional		$398.11	$398.11	$398.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $194.98	Professional		$173.78	$173.78	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $125.89 / $263.03	Facility		$15.85	$125.89	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $213.80	Professional		$91.20	$114.82	$213.80