Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $5,812.00 / $16,243.98	Facility		$550.00	$5,812.00	$16,243.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.66 / $202.01 / $577.40	Professional		$141.66	$202.01	$577.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.48 / $121.83 / $121.83	Professional		$99.48	$121.83	$121.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,931.00 / $11,456.00	Facility		$2,143.00	$5,931.00	$11,456.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.76 / $212.81 / $493.17	Professional		$151.76	$212.81	$493.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $100.00 / $6,881.37	Facility		$65.90	$100.00	$6,881.37
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $143.09 / $204.42 / $427.19	Professional		$143.09	$204.42	$427.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.82 / $248.15 / $493.54	Professional		$175.82	$248.15	$493.54
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $101.27 / $247.24 / $349.97	Professional		$101.27	$247.24	$349.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.64 / $267.32 / $454.18	Professional		$186.64	$267.32	$454.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,256.88 / $4,017.35 / $16,394.00	Facility		$1,256.88	$4,017.35	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,325.36 / $1,723.76 / $2,022.23	Professional		$1,325.36	$1,723.76	$2,022.23
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 $182.45 / $256.69 / $353.44	Facility		$182.45	$256.69	$353.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.09 / $260.98 / $505.56	Professional		$177.09	$260.98	$505.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $581.29 / $581.29 / $773.65	Professional		$581.29	$581.29	$773.65
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $113.42 / $178.79 / $265.08	Professional		$113.42	$178.79	$265.08
United Facility/Professional Facility Modifier Low / Median / High Price $2,348.00 / $4,243.00 / $9,131.00	Facility		$2,348.00	$4,243.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $178.74 / $238.60 / $691.67	Professional		$178.74	$238.60	$691.67