Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $563.00 / $6,229.00 / $18,315.16	Facility		$563.00	$6,229.00	$18,315.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.14 / $360.24 / $779.33	Professional		$184.14	$360.24	$779.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.15 / $148.21 / $162.29	Professional		$81.15	$148.21	$162.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $7,362.00 / $16,106.00	Facility		$2,456.00	$7,362.00	$16,106.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.10 / $387.75 / $972.97	Professional		$278.10	$387.75	$972.97
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,393.26	Facility		$66.00	$100.00	$8,393.26
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $275.47 / $462.38 / $855.79	Professional		$275.47	$462.38	$855.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $9,477.69 / $16,974.98	Facility		$2,277.00	$9,477.69	$16,974.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.23 / $480.53 / $864.94	Professional		$221.23	$480.53	$864.94
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $192.85 / $251.13 / $641.76	Professional		$192.85	$251.13	$641.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.19 / $392.13 / $720.35	Professional		$181.19	$392.13	$720.35
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $837.80 / $885.54 / $26,542.00	Facility		$837.80	$885.54	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $82.05 / $88.55 / $88.55	Facility	AS	$82.05	$88.55	$88.55
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,453.40 / $2,984.33 / $3,210.68	Professional		$1,453.40	$2,984.33	$3,210.68
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 $210.60 / $441.92 / $686.38	Facility		$210.60	$441.92	$686.38
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $151.47 / $151.47 / $151.47	Facility	80	$151.47	$151.47	$151.47
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $30.59 / $30.59 / $128.76	Facility	AS	$30.59	$30.59	$128.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $223.57 / $487.38 / $950.75	Professional		$223.57	$487.38	$950.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $597.36 / $597.36 / $1,355.92	Professional		$597.36	$597.36	$1,355.92
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $182.39 / $316.16 / $528.25	Professional		$182.39	$316.16	$528.25
United Facility/Professional Facility Modifier Low / Median / High Price $5,200.00 / $9,539.00 / $20,217.00	Facility		$5,200.00	$9,539.00	$20,217.00
United Facility/Professional Professional Modifier Low / Median / High Price $322.11 / $453.96 / $956.78	Professional		$322.11	$453.96	$956.78