Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.43 / $4,749.00 / $16,125.00	Facility		$195.43	$4,749.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $178.59 / $557.64	Professional		$111.95	$178.59	$557.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.68 / $183.70 / $334.12	Professional		$79.68	$183.70	$334.12
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 $120.05 / $184.50 / $415.72	Professional		$120.05	$184.50	$415.72
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 $105.93 / $153.32 / $330.94	Professional		$105.93	$153.32	$330.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.49 / $195.10 / $393.00	Professional		$124.49	$195.10	$393.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $165.60 / $289.02	Professional		$68.88	$165.60	$289.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.59 / $210.14 / $371.04	Professional		$124.59	$210.14	$371.04
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $573.79 / $620.02	Facility		$55.00	$573.79	$620.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $897.20 / $1,400.56 / $1,616.93	Professional		$897.20	$1,400.56	$1,616.93
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 $115.56 / $177.20 / $287.97	Facility		$115.56	$177.20	$287.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $203.31 / $405.59	Professional		$124.64	$203.31	$405.59
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $407.53 / $407.53 / $635.94	Professional		$407.53	$407.53	$635.94
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $77.14 / $121.60 / $219.03	Professional		$77.14	$121.60	$219.03
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 $146.07 / $190.75 / $444.69	Professional		$146.07	$190.75	$444.69