Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.52 / $4,749.00 / $16,125.00	Facility		$208.52	$4,749.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.51 / $191.19 / $500.54	Professional		$125.51	$191.19	$500.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.77 / $195.77 / $354.35	Professional		$195.77	$195.77	$354.35
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 $135.01 / $201.06 / $433.90	Professional		$135.01	$201.06	$433.90
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 $115.13 / $164.47 / $355.71	Professional		$115.13	$164.47	$355.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.26 / $212.49 / $417.11	Professional		$138.26	$212.49	$417.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $184.13 / $305.60	Professional		$78.93	$184.13	$305.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.96 / $224.15 / $393.72	Professional		$138.96	$224.15	$393.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $941.76 / $959.16	Facility		$55.00	$941.76	$959.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,001.44 / $1,492.88 / $1,721.93	Professional		$1,001.44	$1,492.88	$1,721.93
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 $133.59 / $194.04 / $305.60	Facility		$133.59	$194.04	$305.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.04 / $218.77 / $432.86	Professional		$139.04	$218.77	$432.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $455.10 / $455.10 / $677.50	Professional		$455.10	$455.10	$677.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $88.40 / $142.07 / $231.59	Professional		$88.40	$142.07	$231.59
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $5,830.00	Facility		$548.00	$1,533.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $153.36 / $208.98 / $464.63	Professional		$153.36	$208.98	$464.63