Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $413.24 / $3,226.00 / $11,257.00	Facility		$413.24	$3,226.00	$11,257.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $33.03 / $59.25 / $403.45	Facility	52	$33.03	$59.25	$403.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $125.78 / $554.40	Professional		$66.04	$125.78	$554.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.63 / $115.85 / $687.65	Professional		$103.63	$115.85	$687.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $4,597.00 / $9,274.00	Facility		$2,143.00	$4,597.00	$9,274.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.47 / $144.13 / $322.69	Professional		$74.47	$144.13	$322.69
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $2,112.61	Facility		$66.09	$100.00	$2,112.61
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $75.67 / $133.35 / $265.10	Professional		$75.67	$133.35	$265.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $477.02 / $563.75 / $1,328.15	Facility		$477.02	$563.75	$1,328.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.69 / $141.72 / $352.27	Professional		$76.69	$141.72	$352.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $111.69 / $211.21	Professional		$78.93	$111.69	$211.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.30 / $136.29 / $243.71	Professional		$72.30	$136.29	$243.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $277.52 / $351.60 / $351.60	Facility		$277.52	$351.60	$351.60
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $148.81 / $281.27 / $281.27	Facility	52	$148.81	$281.27	$281.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $529.12 / $963.36 / $1,111.88	Professional		$529.12	$963.36	$1,111.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.51 / $127.73 / $215.33	Facility		$80.51	$127.73	$215.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.39 / $149.83 / $349.83	Professional		$79.39	$149.83	$349.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $234.29 / $234.29 / $426.64	Professional		$234.29	$234.29	$426.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $131.30 / $180.54	Professional		$72.50	$131.30	$180.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,731.00 / $7,940.00	Facility		$1,371.00	$2,731.00	$7,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.90 / $150.90 / $389.29	Professional		$105.90	$150.90	$389.29