Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $771.65 / $5,980.00 / $16,125.00	Facility		$771.65	$5,980.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $385.83 / $751.51	Professional		$104.04	$385.83	$751.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.86 / $115.86 / $115.86	Professional		$115.86	$115.86	$115.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,400.00	Facility		$2,137.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.40 / $404.12 / $1,442.87	Professional		$144.40	$404.12	$1,442.87
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,663.63	Facility		$66.00	$100.00	$6,663.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $130.76 / $500.80 / $1,178.03	Professional		$130.76	$500.80	$1,178.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,390.96 / $1,393.42 / $2,491.26	Facility		$1,390.96	$1,393.42	$2,491.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.47 / $343.56 / $1,114.27	Professional		$125.47	$343.56	$1,114.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $142.61 / $187.80 / $640.52	Professional		$142.61	$187.80	$640.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $359.84 / $712.67	Professional		$129.47	$359.84	$712.67
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $612.24 / $629.71 / $16,394.00	Facility		$612.24	$629.71	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,385.32 / $5,520.83 / $5,686.46	Professional		$1,385.32	$5,520.83	$5,686.46
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 $130.79 / $335.14 / $722.13	Facility		$130.79	$335.14	$722.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.74 / $349.87 / $1,074.39	Professional		$127.74	$349.87	$1,074.39
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $431.74 / $431.74 / $1,407.89	Professional		$431.74	$431.74	$1,407.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $129.56 / $244.14 / $527.51	Professional		$129.56	$244.14	$527.51
United Facility/Professional Facility Modifier Low / Median / High Price $2,048.00 / $4,038.00 / $9,072.00	Facility		$2,048.00	$4,038.00	$9,072.00
United Facility/Professional Professional Modifier Low / Median / High Price $327.82 / $553.89 / $1,179.89	Professional		$327.82	$553.89	$1,179.89