Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.12 / $4,429.00 / $16,109.00	Facility		$178.12	$4,429.00	$16,109.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.31 / $163.24 / $714.00	Professional		$95.31	$163.24	$714.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.55 / $174.88 / $413.87	Professional		$165.55	$174.88	$413.87
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 $108.55 / $166.45 / $366.22	Professional		$108.55	$166.45	$366.22
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,142.12	Facility		$66.00	$100.00	$5,142.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $97.32 / $139.03 / $300.36	Professional		$97.32	$139.03	$300.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.68 / $177.03 / $363.87	Professional		$112.68	$177.03	$363.87
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $150.43 / $267.68	Professional		$60.68	$150.43	$267.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.88 / $193.69 / $343.00	Professional		$112.88	$193.69	$343.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $518.88 / $562.26	Facility		$55.00	$518.88	$562.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $811.68 / $1,291.28 / $1,492.43	Professional		$811.68	$1,291.28	$1,492.43
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 $104.32 / $161.50 / $265.27	Facility		$104.32	$161.50	$265.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $113.56 / $184.45 / $368.38	Professional		$113.56	$184.45	$368.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $366.97 / $366.97 / $585.76	Professional		$366.97	$366.97	$585.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.97 / $107.14 / $202.88	Professional		$67.97	$107.14	$202.88
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,528.00 / $6,323.00	Facility		$587.00	$1,528.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $132.60 / $176.50 / $407.72	Professional		$132.60	$176.50	$407.72