Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.00 / $4,950.00 / $15,877.00	Facility		$411.00	$4,950.00	$15,877.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.84 / $200.18 / $587.25	Professional		$103.84	$200.18	$587.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.70 / $126.44 / $239.56	Professional		$104.70	$126.44	$239.56
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 $139.74 / $216.77 / $485.07	Professional		$139.74	$216.77	$485.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $100.00 / $5,142.12	Facility		$65.90	$100.00	$5,142.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $194.55 / $408.23	Professional		$129.84	$194.55	$408.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.06 / $249.92 / $504.12	Professional		$158.06	$249.92	$504.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $84.51 / $220.05 / $366.22	Professional		$84.51	$220.05	$366.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.75 / $268.17 / $470.10	Professional		$164.75	$268.17	$470.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $737.24 / $9,102.00 / $11,500.00	Facility		$737.24	$9,102.00	$11,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,179.44 / $1,771.20 / $2,053.19	Professional		$1,179.44	$1,771.20	$2,053.19
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 $147.90 / $224.42 / $363.63	Facility		$147.90	$224.42	$363.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.84 / $262.80 / $511.78	Professional		$160.84	$262.80	$511.78
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $531.32 / $531.32 / $818.63	Professional		$531.32	$531.32	$818.63
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $94.65 / $154.60 / $277.52	Professional		$94.65	$154.60	$277.52
United Facility/Professional Facility Modifier Low / Median / High Price $570.00 / $1,523.00 / $5,691.00	Facility		$570.00	$1,523.00	$5,691.00
United Facility/Professional Professional Modifier Low / Median / High Price $186.30 / $247.18 / $562.86	Professional		$186.30	$247.18	$562.86