Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,464.48 / $7,550.00 / $17,030.00	Facility		$2,464.48	$7,550.00	$17,030.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $643.03 / $910.84 / $3,516.00	Professional		$643.03	$910.84	$3,516.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $654.27 / $654.27 / $1,685.71	Professional		$654.27	$654.27	$1,685.71
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 $835.02 / $1,138.69 / $2,189.32	Professional		$835.02	$1,138.69	$2,189.32
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $8,389.08	Facility		$66.90	$100.00	$8,389.08
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $551.52 / $789.96 / $1,760.19	Professional		$551.52	$789.96	$1,760.19
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 $740.80 / $937.60 / $2,016.71	Professional		$740.80	$937.60	$2,016.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $609.08 / $829.22 / $1,685.12	Professional		$609.08	$829.22	$1,685.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $692.76 / $942.44 / $1,714.05	Professional		$692.76	$942.44	$1,714.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,149.54 / $6,817.20	Facility		$55.00	$4,149.54	$6,817.20
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $165.08 / $646.16 / $646.16	Facility	AS	$165.08	$646.16	$646.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,285.68 / $5,399.12 / $6,382.80	Professional		$5,285.68	$5,399.12	$6,382.80
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 $748.08 / $931.95 / $1,283.02	Facility		$748.08	$931.95	$1,283.02
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $83.10 / $83.10 / $240.59	Facility	AS	$83.10	$83.10	$240.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $740.80 / $983.14 / $1,979.40	Professional		$740.80	$983.14	$1,979.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,376.06 / $2,376.06 / $2,376.06	Professional		$2,376.06	$2,376.06	$2,376.06
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $668.77 / $791.81 / $1,035.44	Professional		$668.77	$791.81	$1,035.44
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 $577.26 / $791.07 / $1,630.10	Professional		$577.26	$791.07	$1,630.10