Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.88 / $4,848.00 / $16,125.00	Facility		$190.88	$4,848.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $174.56 / $336.62	Professional		$111.35	$174.56	$336.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.71 / $175.71 / $179.27	Professional		$175.71	$175.71	$179.27
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 $119.71 / $180.92 / $396.46	Professional		$119.71	$180.92	$396.46
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 $104.85 / $149.78 / $323.18	Professional		$104.85	$149.78	$323.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.46 / $191.08 / $383.90	Professional		$123.46	$191.08	$383.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $164.27 / $281.57	Professional		$67.76	$164.27	$281.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.58 / $204.24 / $361.76	Professional		$123.58	$204.24	$361.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $836.76 / $853.50	Facility		$55.00	$836.76	$853.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $889.60 / $1,366.80 / $1,577.85	Professional		$889.60	$1,366.80	$1,577.85
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 $114.79 / $173.19 / $281.57	Facility		$114.79	$173.19	$281.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.68 / $198.64 / $395.62	Professional		$123.68	$198.64	$395.62
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $404.02 / $404.02 / $620.41	Professional		$404.02	$404.02	$620.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $75.89 / $119.63 / $213.38	Professional		$75.89	$119.63	$213.38
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 $142.06 / $190.25 / $425.95	Professional		$142.06	$190.25	$425.95