Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,616.00 / $10,596.00 / $26,826.00	Facility		$2,616.00	$10,596.00	$26,826.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,291.35 / $1,562.50 / $5,786.00	Professional		$1,291.35	$1,562.50	$5,786.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $209.53 / $786.90 / $1,187.11	Professional	AS	$209.53	$786.90	$1,187.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $914.27 / $1,380.37 / $1,728.46	Professional		$914.27	$1,380.37	$1,728.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,320.00 / $12,563.00 / $29,048.00	Facility		$4,320.00	$12,563.00	$29,048.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,711.81 / $2,210.16 / $4,104.60	Professional		$1,711.81	$2,210.16	$4,104.60
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $189.72 / $228.55 / $293.07	Professional	AS	$189.72	$228.55	$293.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $8,578.84	Facility		$64.40	$100.00	$8,578.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,182.59 / $1,693.59 / $3,764.39	Professional		$1,182.59	$1,693.59	$3,764.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,000.00 / $25,198.00 / $50,000.00	Facility		$8,000.00	$25,198.00	$50,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,454.64 / $1,825.72 / $3,893.90	Professional		$1,454.64	$1,825.72	$3,893.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,633.98 / $1,797.38 / $20,357.74	Professional		$1,633.98	$1,797.38	$20,357.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,333.79 / $1,851.86 / $3,368.47	Professional		$1,333.79	$1,851.86	$3,368.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $14,797.86 / $82,357.35	Facility		$55.00	$14,797.86	$82,357.35
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $325.52 / $7,806.31 / $7,806.31	Facility	AS	$325.52	$7,806.31	$7,806.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,391.76 / $10,613.28 / $12,346.43	Professional		$10,391.76	$10,613.28	$12,346.43
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 $1,509.75 / $1,903.92 / $2,989.66	Facility		$1,509.75	$1,903.92	$2,989.66
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $550.28 / $550.28 / $550.28	Facility	80	$550.28	$550.28	$550.28
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $161.91 / $161.91 / $467.74	Facility	AS	$161.91	$161.91	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,454.64 / $1,900.16 / $3,855.15	Professional		$1,454.64	$1,900.16	$3,855.15
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $366.00 / $392.51 / $399,840.00	Professional	AS	$366.00	$392.51	$399,840.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,700.66 / $4,700.66 / $4,700.66	Professional		$4,700.66	$4,700.66	$4,700.66
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,318.40 / $1,483.20 / $1,812.80	Professional		$1,318.40	$1,483.20	$1,812.80
United Facility/Professional Facility Modifier Low / Median / High Price $10,794.00 / $18,515.00 / $43,752.79	Facility		$10,794.00	$18,515.00	$43,752.79
United Facility/Professional Professional Modifier Low / Median / High Price $1,166.58 / $1,553.26 / $3,198.37	Professional		$1,166.58	$1,553.26	$3,198.37