Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,095.13 / $6,322.00 / $16,756.00	Facility		$1,095.13	$6,322.00	$16,756.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $767.78 / $1,015.26 / $4,457.30	Professional		$767.78	$1,015.26	$4,457.30
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $25.11 / $487.61 / $920.60	Professional	AS	$25.11	$487.61	$920.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $878.49 / $992.66 / $2,046.80	Professional		$878.49	$992.66	$2,046.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.00 / $8,823.00 / $17,774.00	Facility		$3,388.00	$8,823.00	$17,774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $793.71 / $1,108.54 / $2,293.44	Professional		$793.71	$1,108.54	$2,293.44
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $121.90 / $149.78 / $183.96	Professional	AS	$121.90	$149.78	$183.96
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,011.98	Facility		$66.00	$100.00	$8,011.98
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $840.00 / $1,200.00 / $2,513.90	Professional		$840.00	$1,200.00	$2,513.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $882.31 / $1,196.45 / $2,377.69	Professional		$882.31	$1,196.45	$2,377.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $888.68 / $1,298.28 / $1,752.68	Professional		$888.68	$1,298.28	$1,752.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $868.24 / $1,205.44 / $2,225.57	Professional		$868.24	$1,205.44	$2,225.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,958.84 / $6,085.56	Facility		$55.00	$5,958.84	$6,085.56
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $397.38 / $436.07 / $436.07	Facility	AS	$397.38	$436.07	$436.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,285.28 / $7,360.28 / $9,170.62	Professional		$6,285.28	$7,360.28	$9,170.62
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 $835.67 / $1,169.90 / $1,642.54	Facility		$835.67	$1,169.90	$1,642.54
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $412.42 / $412.42 / $412.42	Facility	80	$412.42	$412.42	$412.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $350.56 / $350.56 / $350.56	Facility	AS	$350.56	$350.56	$350.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $888.99 / $1,250.99 / $2,416.39	Professional		$888.99	$1,250.99	$2,416.39
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $270.67 / $328.06 / $392.25	Professional	AS	$270.67	$328.06	$392.25
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,839.80 / $2,839.80 / $3,543.06	Professional		$2,839.80	$2,839.80	$3,543.06
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $810.99 / $1,115.10 / $1,441.89	Professional		$810.99	$1,115.10	$1,441.89
United Facility/Professional Facility Modifier Low / Median / High Price $5,670.00 / $9,758.00 / $21,278.00	Facility		$5,670.00	$9,758.00	$21,278.00
United Facility/Professional Professional Modifier Low / Median / High Price $833.23 / $1,106.55 / $2,374.10	Professional		$833.23	$1,106.55	$2,374.10