Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $6,760.83 / $17,378.01	Facility		$1,905.46	$6,760.83	$17,378.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,122.02 / $4,570.88	Professional		$724.44	$1,122.02	$4,570.88
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $61.66 / $489.78 / $912.01	Professional	AS	$61.66	$489.78	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,445.44 / $2,089.30	Professional		$1,000.00	$1,445.44	$2,089.30
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $288.40 / $288.40 / $288.40	Professional	AS	$288.40	$288.40	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $10,471.29 / $17,782.79	Facility		$6,025.60	$10,471.29	$17,782.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,288.25 / $2,754.23	Professional		$870.96	$1,288.25	$2,754.23
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $117.49 / $158.49 / $204.17	Professional	AS	$117.49	$158.49	$204.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $3,162.28 / $9,332.54	Facility		$66.07	$3,162.28	$9,332.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,380.38 / $3,162.28	Professional		$1,000.00	$1,380.38	$3,162.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,202.26 / $2,238.72	Professional		$870.96	$1,202.26	$2,238.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,071.52 / $1,659.59	Professional		$891.25	$1,071.52	$1,659.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,202.26 / $2,137.96	Professional		$794.33	$1,202.26	$2,137.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $11,220.18	Facility		$54.95	$56.23	$11,220.18
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility	AS	$1,122.02	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,762.47 / $9,120.11 / $9,120.11	Professional		$7,762.47	$9,120.11	$9,120.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,548.82	Professional		$912.01	$912.01	$1,548.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,096.48 / $1,698.24	Facility		$776.25	$1,096.48	$1,698.24
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	AS	$147.91	$147.91	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,202.26 / $2,290.87	Professional		$870.96	$1,202.26	$2,290.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $2,818.38 / $3,548.13	Professional		$2,818.38	$2,818.38	$3,548.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,148.15 / $1,548.82	Professional		$794.33	$1,148.15	$1,548.82
United Facility/Professional Facility Modifier Low / Median / High Price $5,623.41 / $10,000.00 / $20,892.96	Facility		$5,623.41	$10,000.00	$20,892.96
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,023.29 / $1,995.26	Professional		$724.44	$1,023.29	$1,995.26