Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.28 / $4,749.00 / $16,125.00	Facility		$180.28	$4,749.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.21 / $165.18 / $316.74	Professional		$108.21	$165.18	$316.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.71 / $167.71 / $167.71	Professional		$167.71	$167.71	$167.71
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 $116.47 / $172.82 / $384.76	Professional		$116.47	$172.82	$384.76
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 $119.50 / $182.15 / $327.02	Professional		$119.50	$182.15	$327.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.89 / $183.84 / $365.32	Professional		$119.89	$183.84	$365.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $160.66 / $268.44	Professional		$65.90	$160.66	$268.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.88 / $195.58 / $345.29	Professional		$120.88	$195.58	$345.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $818.22 / $832.02	Facility		$55.00	$818.22	$832.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $869.52 / $1,306.16 / $1,508.33	Professional		$869.52	$1,306.16	$1,508.33
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 $112.08 / $167.81 / $268.44	Facility		$112.08	$167.81	$268.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.88 / $189.97 / $373.98	Professional		$120.88	$189.97	$373.98
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $392.16 / $392.16 / $590.52	Professional		$392.16	$392.16	$590.52
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $116.34 / $203.43	Professional		$73.80	$116.34	$203.43
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $5,830.00	Facility		$587.00	$1,551.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.22 / $177.10 / $448.77	Professional		$134.22	$177.10	$448.77