Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.49 / $1,254.54 / $10,223.00	Facility		$288.49	$1,254.54	$10,223.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $489.43 / $999.00 / $3,748.22	Facility	50	$489.43	$999.00	$3,748.22
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $22.80 / $36.89 / $187.42	Facility	52	$22.80	$36.89	$187.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.48 / $80.98 / $284.80	Professional		$45.48	$80.98	$284.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $89.96 / $151.26 / $426.06	Professional	50	$89.96	$151.26	$426.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.74 / $66.22 / $125.95	Professional		$49.74	$66.22	$125.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $62.80 / $94.10 / $167.04	Professional	50	$62.80	$94.10	$167.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,675.00 / $6,783.00 / $13,707.00	Facility		$2,675.00	$6,783.00	$13,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.81 / $90.18 / $156.47	Professional		$57.81	$90.18	$156.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $71.29 / $92.15 / $129.41	Professional	50	$71.29	$92.15	$129.41
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $1,535.04	Facility		$66.90	$100.00	$1,535.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $50.38 / $74.70 / $140.76	Professional		$50.38	$74.70	$140.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.06 / $66.18 / $1,487.00	Facility		$66.06	$66.18	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.08 / $73.62 / $144.53	Professional		$50.08	$73.62	$144.53
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $54.95 / $86.63	Professional		$45.79	$54.95	$86.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.22 / $69.70 / $123.48	Professional		$45.22	$69.70	$123.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $205.87 / $220.97 / $15,000.00	Facility		$205.87	$220.97	$15,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $164.70 / $176.78 / $176.78	Facility	52	$164.70	$176.78	$176.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $325.76 / $468.88 / $550.50	Professional		$325.76	$468.88	$550.50
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 $49.07 / $68.78 / $106.56	Facility		$49.07	$68.78	$106.56
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $79.15 / $153.68	Professional		$50.42	$79.15	$153.68
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $618.00 / $618.00 / $618.00	Facility		$618.00	$618.00	$618.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $148.05 / $148.05 / $202.15	Professional		$148.05	$148.05	$202.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.27 / $62.52 / $85.97	Professional		$45.27	$62.52	$85.97
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,523.00 / $5,830.00	Facility		$526.00	$1,523.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.79 / $70.80 / $138.06	Professional		$47.79	$70.80	$138.06
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $85.00 / $136.40	Professional	50	$80.00	$85.00	$136.40