Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.55 / $6,695.00 / $18,252.00	Facility		$115.55	$6,695.00	$18,252.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.42 / $115.54 / $445.86	Professional		$64.42	$115.54	$445.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $135.49 / $164.18	Professional		$115.00	$135.49	$164.18
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 $63.94 / $111.78 / $250.14	Professional		$63.94	$111.78	$250.14
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 $67.92 / $100.67 / $212.79	Professional		$67.92	$100.67	$212.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.01 / $129.99 / $312.67	Professional		$74.01	$129.99	$312.67
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $96.27 / $232.64	Professional		$43.19	$96.27	$232.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.54 / $159.40 / $293.98	Professional		$74.54	$159.40	$293.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $337.57 / $367.13	Facility		$55.00	$337.57	$367.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $583.78 / $1,113.92 / $1,295.70	Professional		$583.78	$1,113.92	$1,295.70
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 $69.81 / $115.55 / $224.55	Facility		$69.81	$115.55	$224.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.01 / $141.77 / $323.79	Professional		$75.01	$141.77	$323.79
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $247.12 / $247.12 / $528.41	Professional		$247.12	$247.12	$528.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $48.37 / $75.63 / $176.31	Professional		$48.37	$75.63	$176.31
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $5,830.00	Facility		$548.00	$1,533.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $108.82 / $148.83 / $364.06	Professional		$108.82	$148.83	$364.06