Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.19 / $4,011.00 / $14,970.00	Facility		$201.19	$4,011.00	$14,970.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.34 / $178.16 / $867.62	Professional		$108.34	$178.16	$867.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.27 / $201.27 / $201.27	Professional		$201.27	$201.27	$201.27
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 $196.88 / $256.83 / $501.22	Professional		$196.88	$256.83	$501.22
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,881.37	Facility		$66.00	$100.00	$6,881.37
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $130.32 / $214.83 / $420.38	Professional		$130.32	$214.83	$420.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.79 / $248.41 / $463.67	Professional		$156.79	$248.41	$463.67
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $156.74 / $203.90 / $333.34	Professional		$156.74	$203.90	$333.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.71 / $245.87 / $435.87	Professional		$153.71	$245.87	$435.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,047.66 / $2,000.00 / $16,394.00	Facility		$1,047.66	$2,000.00	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,130.00 / $1,669.92 / $1,955.40	Professional		$1,130.00	$1,669.92	$1,955.40
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 $149.32 / $252.22 / $370.27	Facility		$149.32	$252.22	$370.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $157.88 / $263.27 / $463.67	Professional		$157.88	$263.27	$463.67
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $500.48 / $500.48 / $761.35	Professional		$500.48	$500.48	$761.35
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $154.26 / $224.38 / $308.52	Professional		$154.26	$224.38	$308.52
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,501.00 / $6,316.00	Facility		$587.00	$1,501.00	$6,316.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.28 / $239.66 / $505.36	Professional		$179.28	$239.66	$505.36