Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,848.00 / $16,573.00	Facility		$344.00	$4,848.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $189.59 / $205.70 / $1,379.97	Facility	54	$189.59	$205.70	$1,379.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.75 / $274.27 / $845.08	Professional		$237.75	$274.27	$845.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,464.00 / $8,976.00	Facility		$1,723.00	$4,464.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.98 / $382.32 / $773.02	Professional		$303.98	$382.32	$773.02
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,367.09	Facility		$66.00	$100.00	$5,367.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $180.69 / $254.25 / $585.94	Professional		$180.69	$254.25	$585.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.20 / $253.65 / $1,487.00	Facility		$253.20	$253.65	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.27 / $358.70 / $760.71	Professional		$273.27	$358.70	$760.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $137.01 / $360.16 / $486.22	Professional		$137.01	$360.16	$486.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.47 / $403.95 / $715.07	Professional		$302.47	$403.95	$715.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.48 / $1,543.89 / $12,000.00	Facility		$1,412.48	$1,543.89	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $972.78 / $1,080.72 / $1,080.72	Facility	54	$972.78	$1,080.72	$1,080.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,172.80 / $2,321.92 / $2,722.58	Professional		$2,172.80	$2,321.92	$2,722.58
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 $310.23 / $391.46 / $522.23	Facility		$310.23	$391.46	$522.23
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $594.86	Facility	54	$354.25	$354.25	$594.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $275.74 / $376.76 / $788.14	Professional		$275.74	$376.76	$788.14
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $949.54 / $949.54 / $988.01	Professional		$949.54	$949.54	$988.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $191.81 / $311.00 / $421.23	Professional		$191.81	$311.00	$421.23
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $6,323.00	Facility		$548.00	$1,533.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $234.90 / $307.87 / $724.68	Professional		$234.90	$307.87	$724.68