Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $546.00 / $4,704.00 / $15,277.00	Facility		$546.00	$4,704.00	$15,277.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $165.17 / $587.36	Professional		$86.14	$165.17	$587.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.05 / $103.06 / $194.32	Professional		$92.05	$103.06	$194.32
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 $121.34 / $171.04 / $379.89	Professional		$121.34	$171.04	$379.89
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $100.00 / $5,238.60	Facility		$65.90	$100.00	$5,238.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $162.77 / $337.76	Professional		$113.94	$162.77	$337.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.65 / $205.21 / $424.97	Professional		$141.65	$205.21	$424.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $208.43 / $294.60	Professional		$81.16	$208.43	$294.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.05 / $222.90 / $379.68	Professional		$155.05	$222.90	$379.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $706.08 / $9,102.00 / $11,500.00	Facility		$706.08	$9,102.00	$11,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,095.83 / $1,429.84 / $1,676.93	Professional		$1,095.83	$1,429.84	$1,676.93
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 $139.40 / $196.60 / $294.60	Facility		$139.40	$196.60	$294.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.62 / $212.83 / $424.97	Professional		$143.62	$212.83	$424.97
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $483.72 / $483.72 / $646.01	Professional		$483.72	$483.72	$646.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $90.90 / $146.40 / $223.18	Professional		$90.90	$146.40	$223.18
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 $145.08 / $190.89 / $489.92	Professional		$145.08	$190.89	$489.92