Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $57.43 / $2,750.00	Facility		$30.23	$57.43	$2,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $30.53 / $105.70	Professional		$30.23	$30.53	$105.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.53 / $35.15 / $59.49	Facility		$29.53	$35.15	$59.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $32.02 / $77.19	Professional		$30.23	$32.02	$77.19
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $50.59 / $69.83 / $98.67	Facility		$50.59	$69.83	$98.67
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $41.54 / $92.91	Professional		$29.56	$41.54	$92.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $28.52 / $30.23	Facility		$28.52	$28.52	$30.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $30.23 / $54.41	Professional		$30.23	$30.23	$54.41
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $30.48 / $41.14	Professional		$30.36	$30.48	$41.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $37.79 / $66.51	Professional		$28.27	$37.79	$66.51
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $134.55 / $134.55	Facility		$75.00	$134.55	$134.55
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,212.73 / $2,212.73 / $2,212.73	Professional		$2,212.73	$2,212.73	$2,212.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.39 / $62.48 / $62.48	Professional		$33.39	$62.48	$62.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $36.28 / $54.21	Facility		$30.23	$36.28	$54.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $30.23 / $42.78	Professional		$30.23	$30.23	$42.78
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $69.13 / $69.13	Professional		$69.13	$69.13	$69.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $30.36 / $36.43	Professional		$24.18	$30.36	$36.43
United Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $30.23 / $64.38	Professional		$30.23	$30.23	$64.38