Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.58 / $4,420.00 / $15,234.00	Facility		$202.58	$4,420.00	$15,234.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.87 / $139.72 / $604.82	Professional		$69.87	$139.72	$604.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $84.39 / $150.91	Professional		$73.44	$84.39	$150.91
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 $95.35 / $142.57 / $321.81	Professional		$95.35	$142.57	$321.81
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 $100.00 / $144.78 / $300.44	Professional		$100.00	$144.78	$300.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.74 / $172.04 / $339.72	Professional		$112.74	$172.04	$339.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $160.90 / $258.77	Professional		$71.84	$160.90	$258.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.22 / $189.22 / $331.14	Professional		$119.22	$189.22	$331.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $531.37 / $9,102.00 / $11,500.00	Facility		$531.37	$9,102.00	$11,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $846.32 / $1,240.00 / $1,445.48	Professional		$846.32	$1,240.00	$1,445.48
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 $104.44 / $158.78 / $258.77	Facility		$104.44	$158.78	$258.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.45 / $179.68 / $344.83	Professional		$114.45	$179.68	$344.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $375.27 / $375.27 / $562.80	Professional		$375.27	$375.27	$562.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $122.65 / $196.10	Professional		$80.48	$122.65	$196.10
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 $125.58 / $168.08 / $373.59	Professional		$125.58	$168.08	$373.59