Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.23 / $1,169.00 / $11,067.00	Facility		$182.23	$1,169.00	$11,067.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $63.99 / $76.64 / $571.79	Facility	54	$63.99	$76.64	$571.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.31 / $128.00 / $421.43	Professional		$85.31	$128.00	$421.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $126.17 / $220.85	Professional		$115.50	$126.17	$220.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,863.00 / $11,400.00	Facility		$2,143.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.29 / $106.96 / $230.12	Professional		$77.29	$106.96	$230.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $100.00 / $1,588.01	Facility		$65.90	$100.00	$1,588.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $95.59 / $220.47	Professional		$69.30	$95.59	$220.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $129.57 / $271.61	Professional		$94.52	$129.57	$271.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $151.29 / $190.92	Professional		$42.44	$151.29	$190.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.59 / $152.36 / $262.16	Professional		$110.59	$152.36	$262.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $490.46 / $555.85	Facility		$55.00	$490.46	$555.85
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $343.32 / $389.09 / $389.09	Facility	54	$343.32	$389.09	$389.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $782.96 / $926.08 / $1,071.75	Professional		$782.96	$926.08	$1,071.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.14 / $131.69 / $192.90	Facility		$94.14	$131.69	$192.90
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $237.05 / $237.05 / $237.05	Facility	54	$237.05	$237.05	$237.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.31 / $137.91 / $281.54	Professional		$97.31	$137.91	$281.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $331.67 / $331.67 / $400.19	Professional		$331.67	$331.67	$400.19
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $90.99 / $146.19	Professional		$47.54	$90.99	$146.19
United Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,495.00 / $6,316.00	Facility		$545.00	$1,495.00	$6,316.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.44 / $119.99 / $304.14	Professional		$89.44	$119.99	$304.14