Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $215.83 / $2,231.00 / $13,582.00	Facility		$215.83	$2,231.00	$13,582.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $405.39 / $405.39 / $10,336.00	Facility	50	$405.39	$405.39	$10,336.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.57 / $65.66 / $266.10	Professional		$37.57	$65.66	$266.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $91.24 / $115.90 / $409.50	Professional	50	$91.24	$115.90	$409.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $55.46 / $109.46	Professional		$38.71	$55.46	$109.46
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.56 / $97.48 / $141.86	Professional	50	$70.56	$97.48	$141.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,694.00 / $11,233.00	Facility		$2,137.00	$5,694.00	$11,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $73.06 / $129.80	Professional		$48.47	$73.06	$129.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $58.36 / $77.01 / $110.44	Professional	50	$58.36	$77.01	$110.44
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 $43.13 / $61.71 / $117.22	Professional		$43.13	$61.71	$117.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $56.64 / $1,487.00	Facility		$56.54	$56.64	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.07 / $60.64 / $119.66	Professional		$41.07	$60.64	$119.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $45.56 / $72.52	Professional		$37.97	$45.56	$72.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.63 / $59.02 / $103.39	Professional		$36.63	$59.02	$103.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $166.51 / $179.74 / $15,000.00	Facility		$166.51	$179.74	$15,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $279.00 / $398.32 / $459.60	Professional		$279.00	$398.32	$459.60
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 $41.48 / $57.50 / $89.64	Facility		$41.48	$57.50	$89.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $65.33 / $129.28	Professional		$41.42	$65.33	$129.28
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $121.42 / $121.42 / $170.71	Professional		$121.42	$121.42	$170.71
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $53.16 / $73.25	Professional		$36.95	$53.16	$73.25
United Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $1,506.00 / $5,830.00	Facility		$510.00	$1,506.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $56.68 / $116.45	Professional		$41.18	$56.68	$116.45