Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.98 / $2,594.00 / $13,582.00	Facility		$222.98	$2,594.00	$13,582.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $108.22 / $125.25 / $967.44	Facility	54	$108.22	$125.25	$967.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.69 / $192.83 / $823.00	Professional		$143.69	$192.83	$823.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.11 / $220.20 / $364.38	Professional		$201.11	$220.20	$364.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,882.00 / $4,542.00 / $9,244.00	Facility		$1,882.00	$4,542.00	$9,244.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.55 / $185.30 / $394.24	Professional		$138.55	$185.30	$394.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $231.78 / $287.70 / $401.58	Professional	50	$231.78	$287.70	$401.58
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,238.60	Facility		$66.00	$100.00	$5,238.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $118.24 / $168.91 / $410.20	Professional		$118.24	$168.91	$410.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.79 / $222.46 / $482.33	Professional		$165.79	$222.46	$482.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $75.76 / $252.45 / $311.89	Professional		$75.76	$252.45	$311.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.37 / $254.97 / $435.16	Professional		$186.37	$254.97	$435.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $841.70 / $939.55	Facility		$55.00	$841.70	$939.55
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $589.19 / $657.69 / $657.69	Facility	54	$589.19	$657.69	$657.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,342.08 / $1,552.00 / $1,797.30	Professional		$1,342.08	$1,552.00	$1,797.30
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 $167.72 / $226.03 / $318.30	Facility		$167.72	$226.03	$318.30
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $406.00 / $406.00 / $406.00	Facility	54	$406.00	$406.00	$406.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $168.98 / $238.94 / $493.65	Professional		$168.98	$238.94	$493.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $596.25 / $596.25 / $687.61	Professional		$596.25	$596.25	$687.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $106.06 / $199.51 / $288.77	Professional		$106.06	$199.51	$288.77
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $5,830.00	Facility		$587.00	$1,551.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $156.06 / $208.32 / $569.74	Professional		$156.06	$208.32	$569.74