Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,802.50 / $7,954.32 / $17,809.00	Facility		$2,802.50	$7,954.32	$17,809.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,291.50 / $9,918.00 / $19,796.02	Facility	50	$6,291.50	$9,918.00	$19,796.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.74 / $730.92 / $2,677.00	Professional		$512.74	$730.92	$2,677.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $598.72 / $1,247.68 / $3,250.27	Professional		$598.72	$1,247.68	$3,250.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,629.00 / $7,028.00 / $15,328.00	Facility		$2,629.00	$7,028.00	$15,328.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.03 / $826.64 / $1,841.91	Professional		$660.03	$826.64	$1,841.91
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $8,427.70	Facility		$66.70	$100.00	$8,427.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $348.24 / $545.04 / $1,365.71	Professional		$348.24	$545.04	$1,365.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,943.01 / $2,296.29 / $5,409.85	Facility		$1,943.01	$2,296.29	$5,409.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.64 / $810.22 / $2,204.88	Professional		$433.64	$810.22	$2,204.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $333.58 / $730.92 / $986.74	Professional		$333.58	$730.92	$986.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $657.83 / $841.52 / $1,517.68	Professional		$657.83	$841.52	$1,517.68
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,470.04 / $8,723.79 / $26,542.00	Facility		$2,470.04	$8,723.79	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $146.26 / $826.90 / $826.90	Facility	AS	$146.26	$826.90	$826.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,694.80 / $4,805.92 / $5,710.43	Professional		$4,694.80	$4,805.92	$5,710.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $638.29 / $818.52 / $1,177.93	Facility		$638.29	$818.52	$1,177.93
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $253.62 / $253.62 / $253.62	Facility	80	$253.62	$253.62	$253.62
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $215.58 / $215.58 / $215.58	Facility	AS	$215.58	$215.58	$215.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $419.01 / $829.13 / $1,855.87	Professional		$419.01	$829.13	$1,855.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,106.07 / $2,106.07 / $2,106.07	Professional		$2,106.07	$2,106.07	$2,106.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $333.58 / $589.29 / $810.29	Professional		$333.58	$589.29	$810.29
United Facility/Professional Facility Modifier Low / Median / High Price $3,610.00 / $7,402.00 / $16,148.00	Facility		$3,610.00	$7,402.00	$16,148.00
United Facility/Professional Professional Modifier Low / Median / High Price $507.87 / $771.22 / $2,161.40	Professional		$507.87	$771.22	$2,161.40