Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $2,187.76 / $6,025.60	Facility		$141.25	$2,187.76	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $141.25 / $602.56	Professional		$138.04	$141.25	$602.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $162.18 / $190.55	Facility		$144.54	$162.18	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $302.00	Professional		$138.04	$158.49	$302.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $186.21	Professional		$39.81	$39.81	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $138.04	Facility		$131.83	$131.83	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $169.82	Professional		$138.04	$138.04	$169.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $234.42	Professional		$134.90	$177.83	$234.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $269.15	Professional		$131.83	$173.78	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Professional		$1,445.44	$1,445.44	$1,445.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $154.88 / $281.84	Facility		$138.04	$154.88	$281.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $177.83	Professional		$125.89	$125.89	$177.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $204.17	Professional		$134.90	$162.18	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $229.09 / $251.19	Professional		$125.89	$229.09	$251.19