Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.00 / $6,423.00 / $17,286.38	Facility		$1,169.00	$6,423.00	$17,286.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.28 / $146.91 / $512.79	Professional		$127.28	$146.91	$512.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.85 / $136.62 / $206.30	Professional		$90.85	$136.62	$206.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.37 / $197.53 / $520.22	Facility		$163.37	$197.53	$520.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.34 / $408.81	Professional		$165.96	$213.34	$408.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $27,955.87	Facility		$77.09	$100.00	$27,955.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $102.32 / $147.85 / $331.96	Professional		$102.32	$147.85	$331.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,277.00 / $2,277.00	Facility		$2,277.00	$2,277.00	$2,277.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.72 / $181.94 / $394.92	Professional		$144.72	$181.94	$394.92
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $110.95 / $155.91 / $194.89	Professional		$110.95	$155.91	$194.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.97 / $181.78 / $341.00	Professional		$131.97	$181.78	$341.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $528.12 / $696.49	Facility		$55.00	$528.12	$696.49
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $28.01 / $65.55 / $69.65	Facility	AS	$28.01	$65.55	$69.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,264.28 / $1,902.24 / $1,902.24	Professional		$1,264.28	$1,902.24	$1,902.24
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 $143.38 / $179.27 / $249.26	Facility		$143.38	$179.27	$249.26
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $54.99 / $54.99 / $54.99	Facility	80	$54.99	$54.99	$54.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $16.03 / $16.03 / $46.74	Facility	AS	$16.03	$16.03	$46.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.44 / $188.64 / $384.56	Professional		$143.44	$188.64	$384.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $469.95 / $469.95 / $469.95	Professional		$469.95	$469.95	$469.95
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $125.72 / $144.22 / $188.61	Professional		$125.72	$144.22	$188.61
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $6,323.00	Facility		$587.00	$1,551.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.77 / $152.63 / $320.38	Professional		$114.77	$152.63	$320.38