Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.89 / $3,989.00 / $16,008.00	Facility		$94.89	$3,989.00	$16,008.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $735.00 / $1,788.60 / $2,076.86	Facility	50	$735.00	$1,788.60	$2,076.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $87.21 / $330.82	Professional		$51.90	$87.21	$330.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.04 / $343.79 / $570.00	Professional	50	$109.04	$343.79	$570.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.89 / $80.39 / $425.62	Professional		$51.89	$80.39	$425.62
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $214.20 / $214.20 / $214.20	Professional	50	$214.20	$214.20	$214.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,464.00 / $8,976.00	Facility		$1,723.00	$4,464.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $95.58 / $176.87	Professional		$67.36	$95.58	$176.87
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $85.18 / $112.18 / $163.75	Professional	50	$85.18	$112.18	$163.75
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.46 / $82.20 / $167.52	Professional		$60.46	$82.20	$167.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.94 / $89.10 / $1,487.00	Facility		$88.94	$89.10	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $86.62 / $163.59	Professional		$59.90	$86.62	$163.59
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $66.68 / $109.60	Professional		$52.49	$66.68	$109.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.01 / $89.32 / $156.31	Professional		$57.01	$89.32	$156.31
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $258.85 / $279.35	Facility		$55.00	$258.85	$279.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $408.88 / $613.73 / $703.20	Professional		$408.88	$613.73	$703.20
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 $58.14 / $84.89 / $127.62	Facility		$58.14	$84.89	$127.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $91.42 / $193.50	Professional		$61.56	$91.42	$193.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $184.75 / $184.75 / $256.88	Professional		$184.75	$184.75	$256.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $73.48 / $110.66	Professional		$52.49	$73.48	$110.66
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,506.00 / $5,830.00	Facility		$526.00	$1,506.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.90 / $80.41 / $175.85	Professional		$60.90	$80.41	$175.85