Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,965.99 / $5,990.00 / $12,774.00	Facility		$1,965.99	$5,990.00	$12,774.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.08 / $127.18 / $809.04	Facility	53	$32.08	$127.18	$809.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.57 / $635.89 / $3,169.00	Professional		$158.57	$635.89	$3,169.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $486.70 / $486.70 / $486.70	Professional		$486.70	$486.70	$486.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,870.00 / $11,715.00	Facility		$2,143.00	$5,870.00	$11,715.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.47 / $816.40 / $1,733.42	Professional		$206.47	$816.40	$1,733.42
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $7,182.43	Facility		$66.70	$100.00	$7,182.43
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $169.32 / $478.64 / $1,223.90	Professional		$169.32	$478.64	$1,223.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $894.77 / $1,057.45 / $2,491.26	Facility		$894.77	$1,057.45	$2,491.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.68 / $658.48 / $1,709.30	Professional		$183.68	$658.48	$1,709.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $632.16 / $840.62	Professional		$175.61	$632.16	$840.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.88 / $468.88 / $919.33	Professional		$160.88	$468.88	$919.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $781.85 / $896.55	Facility		$55.00	$781.85	$896.55
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $82.96 / $156.37 / $156.37	Facility	53	$82.96	$156.37	$156.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,820.49 / $3,502.96 / $4,077.23	Professional		$1,820.49	$3,502.96	$4,077.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $179.12 / $442.73 / $854.50	Facility		$179.12	$442.73	$854.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $187.99 / $681.64 / $1,612.89	Professional		$187.99	$681.64	$1,612.89
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $545.15 / $545.15 / $2,050.23	Professional		$545.15	$545.15	$2,050.23
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $161.34 / $632.16 / $948.25	Professional		$161.34	$632.16	$948.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,150.00 / $4,218.00 / $10,979.00	Facility		$2,150.00	$4,218.00	$10,979.00
United Facility/Professional Professional Modifier Low / Median / High Price $502.86 / $741.40 / $2,420.42	Professional		$502.86	$741.40	$2,420.42