Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.62 / $2,903.00 / $14,970.00	Facility		$57.62	$2,903.00	$14,970.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.44 / $45.89 / $204.00	Professional		$17.44	$45.89	$204.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.44 / $56.44 / $65.84	Professional		$56.44	$56.44	$65.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.73 / $22.10 / $4,604.00	Facility		$17.73	$22.10	$4,604.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.41 / $41.04 / $94.06	Professional		$18.41	$41.04	$94.06
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $25.00 / $62.08 / $112.12	Professional	50	$25.00	$62.08	$112.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $100.00 / $1,596.84	Facility		$65.90	$100.00	$1,596.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $22.58 / $38.81 / $81.05	Professional		$22.58	$38.81	$81.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $44.75 / $123.73	Professional		$17.14	$44.75	$123.73
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $16.42 / $20.10 / $110.04	Professional		$16.42	$20.10	$110.04
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $181.82 / $181.82 / $181.82	Professional		$181.82	$181.82	$181.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.17 / $65.67 / $136.61	Professional		$15.17	$65.67	$136.61
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $73.91 / $115.02	Facility		$55.00	$73.91	$115.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $260.69 / $504.72 / $589.04	Professional		$260.69	$504.72	$589.04
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 $17.45 / $35.57 / $99.05	Facility		$17.45	$35.57	$99.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $45.27 / $130.79	Professional		$17.50	$45.27	$130.79
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $51.87 / $51.87 / $210.56	Professional		$51.87	$51.87	$210.56
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $14.91 / $27.47 / $101.97	Professional		$14.91	$27.47	$101.97
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,572.00 / $5,830.00	Facility		$587.00	$1,572.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $56.96 / $135.99	Professional		$40.13	$56.96	$135.99