Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $241.39 / $5,189.00 / $16,573.00	Facility		$241.39	$5,189.00	$16,573.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $204.32 / $404.46	Professional		$133.96	$204.32	$404.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.40 / $202.40 / $202.40	Professional		$202.40	$202.40	$202.40
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 $135.55 / $213.31 / $473.23	Professional		$135.55	$213.31	$473.23
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 $137.38 / $200.42 / $412.54	Professional		$137.38	$200.42	$412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.52 / $241.34 / $483.24	Professional		$156.52	$241.34	$483.24
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $168.65 / $220.40 / $353.15	Professional		$168.65	$220.40	$353.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.80 / $257.14 / $453.90	Professional		$158.80	$257.14	$453.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,071.30 / $9,102.00 / $11,500.00	Facility		$1,071.30	$9,102.00	$11,500.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,133.52 / $1,708.48 / $1,991.33	Professional		$1,133.52	$1,708.48	$1,991.33
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 $158.16 / $233.03 / $356.78	Facility		$158.16	$233.03	$356.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $253.81 / $493.86	Professional		$156.97	$253.81	$493.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $509.07 / $509.07 / $789.17	Professional		$509.07	$509.07	$789.17
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $162.51 / $236.11 / $327.05	Professional		$162.51	$236.11	$327.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,731.00 / $7,655.00	Facility		$1,371.00	$2,731.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.28 / $237.30 / $542.91	Professional		$179.28	$237.30	$542.91