Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,820.00 / $6,880.00 / $17,066.61	Facility		$1,820.00	$6,880.00	$17,066.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.32 / $511.49 / $2,030.00	Professional		$394.32	$511.49	$2,030.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $375.00 / $447.65	Professional		$375.00	$375.00	$447.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,944.00 / $13,012.00	Facility		$2,143.00	$5,944.00	$13,012.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $482.89 / $690.74 / $1,328.06	Professional		$482.89	$690.74	$1,328.06
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,854.54	Facility		$66.00	$100.00	$6,854.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $335.80 / $479.72 / $1,070.60	Professional		$335.80	$479.72	$1,070.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,360.35 / $2,364.53 / $5,980.00	Facility		$2,360.35	$2,364.53	$5,980.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.20 / $564.98 / $1,229.97	Professional		$450.20	$564.98	$1,229.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $370.07 / $510.25 / $1,685.12	Professional		$370.07	$510.25	$1,685.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $424.09 / $585.16 / $1,036.66	Professional		$424.09	$585.16	$1,036.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,523.96 / $6,817.20	Facility		$55.00	$2,523.96	$6,817.20
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $100.78 / $646.16 / $646.16	Facility	AS	$100.78	$646.16	$646.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,220.48 / $3,288.48 / $3,883.28	Professional		$3,220.48	$3,288.48	$3,883.28
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 $457.22 / $570.30 / $781.70	Facility		$457.22	$570.30	$781.70
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $50.56 / $50.56 / $145.57	Facility	AS	$50.56	$50.56	$145.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $450.20 / $595.73 / $1,197.70	Professional		$450.20	$595.73	$1,197.70
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,437.58 / $1,437.58 / $1,437.58	Professional		$1,437.58	$1,437.58	$1,437.58
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $411.59 / $481.09 / $629.11	Professional		$411.59	$481.09	$629.11
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,359.00 / $15,471.00	Facility		$3,523.00	$7,359.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $348.03 / $477.80 / $1,076.83	Professional		$348.03	$477.80	$1,076.83