Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,749.00 / $16,125.00	Facility		$344.00	$4,749.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.12 / $112.83 / $434.31	Professional		$71.12	$112.83	$434.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $125.99 / $279.77	Professional		$54.11	$125.99	$279.77
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 $65.31 / $102.95 / $236.48	Professional		$65.31	$102.95	$236.48
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,142.12	Facility		$66.00	$100.00	$5,142.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $67.89 / $108.99 / $215.36	Professional		$67.89	$108.99	$215.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $126.86 / $257.16	Professional		$79.95	$126.86	$257.16
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $58.08 / $119.86 / $195.02	Professional		$58.08	$119.86	$195.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.72 / $141.76 / $248.08	Professional		$87.72	$141.76	$248.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $9,102.00 / $11,500.00	Facility		$389.05	$9,102.00	$11,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $616.64 / $919.68 / $1,079.63	Professional		$616.64	$919.68	$1,079.63
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 $71.56 / $117.03 / $194.21	Facility		$71.56	$117.03	$194.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.89 / $133.38 / $258.43	Professional		$80.89	$133.38	$258.43
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $269.47 / $269.47 / $418.54	Professional		$269.47	$269.47	$418.54
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $65.05 / $95.21 / $147.80	Professional		$65.05	$95.21	$147.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,410.00 / $2,753.00 / $7,655.00	Facility		$1,410.00	$2,753.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $93.08 / $124.84 / $289.16	Professional		$93.08	$124.84	$289.16