Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $530.00 / $6,264.00 / $17,380.00	Facility		$530.00	$6,264.00	$17,380.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.19 / $184.74 / $597.20	Professional		$134.19	$184.74	$597.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.39 / $13.39 / $13.39	Professional		$13.39	$13.39	$13.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $7,007.00 / $14,981.00	Facility		$2,456.00	$7,007.00	$14,981.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.54 / $250.27 / $476.72	Professional		$179.54	$250.27	$476.72
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,138.75	Facility		$66.00	$100.00	$8,138.75
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $138.75 / $198.22 / $439.32	Professional		$138.75	$198.22	$439.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $3,101.23 / $5,554.45	Facility		$2,277.00	$3,101.23	$5,554.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.28 / $236.40 / $445.61	Professional		$163.28	$236.40	$445.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $104.24 / $219.49 / $389.60	Professional		$104.24	$219.49	$389.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.43 / $263.10 / $448.07	Professional		$173.43	$263.10	$448.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,167.18 / $1,182.90 / $26,542.00	Facility		$1,167.18	$1,182.90	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,229.35 / $1,703.33 / $1,992.00	Professional		$1,229.35	$1,703.33	$1,992.00
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 $169.35 / $243.56 / $366.69	Facility		$169.35	$243.56	$366.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.02 / $248.94 / $489.09	Professional		$166.02	$248.94	$489.09
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $516.55 / $516.55 / $701.69	Professional		$516.55	$516.55	$701.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $145.94 / $197.19 / $320.60	Professional		$145.94	$197.19	$320.60
United Facility/Professional Facility Modifier Low / Median / High Price $4,331.00 / $9,713.00 / $21,278.00	Facility		$4,331.00	$9,713.00	$21,278.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.16 / $212.80 / $480.53	Professional		$164.16	$212.80	$480.53