Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,429.00 / $15,877.00	Facility		$344.00	$4,429.00	$15,877.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.16 / $153.31 / $673.05	Professional		$114.16	$153.31	$673.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.34 / $151.34 / $152.56	Professional		$151.34	$151.34	$152.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,539.00 / $9,381.00	Facility		$1,787.00	$4,539.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.54 / $159.66 / $346.01	Professional		$115.54	$159.66	$346.01
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $100.00 / $5,238.60	Facility		$65.80	$100.00	$5,238.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $104.88 / $149.83 / $318.91	Professional		$104.88	$149.83	$318.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $178.93 / $354.54	Professional		$129.22	$178.93	$354.54
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $159.78 / $238.33	Professional		$86.75	$159.78	$238.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.59 / $178.94 / $328.26	Professional		$122.59	$178.94	$328.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $564.64 / $1,300.00 / $12,000.00	Facility		$564.64	$1,300.00	$12,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $902.48 / $1,212.64 / $1,402.43	Professional		$902.48	$1,212.64	$1,402.43
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 $125.43 / $174.31 / $242.96	Facility		$125.43	$174.31	$242.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $129.51 / $189.17 / $360.22	Professional		$129.51	$189.17	$360.22
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $417.60 / $417.60 / $572.67	Professional		$417.60	$417.60	$572.67
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $97.16 / $142.21 / $196.91	Professional		$97.16	$142.21	$196.91
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,572.00 / $5,830.00	Facility		$587.00	$1,572.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $179.51 / $433.05	Professional		$129.47	$179.51	$433.05