Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $4,702.00 / $16,125.00	Facility		$365.00	$4,702.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $148.11 / $162.29 / $1,050.73	Facility	54	$148.11	$162.29	$1,050.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.87 / $217.22 / $684.87	Professional		$183.87	$217.22	$684.87
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 $223.87 / $294.52 / $592.62	Professional		$223.87	$294.52	$592.62
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 $159.69 / $220.55 / $503.72	Professional		$159.69	$220.55	$503.72
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 $206.89 / $275.72 / $584.05	Professional		$206.89	$275.72	$584.05
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $92.93 / $288.80 / $389.88	Professional		$92.93	$288.80	$389.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $235.70 / $316.39 / $565.04	Professional		$235.70	$316.39	$565.04
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,309.26 / $2,088.44 / $12,000.00	Facility		$1,309.26	$2,088.44	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $376.47 / $755.54 / $853.99	Facility	54	$376.47	$755.54	$853.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,692.56 / $1,733.12 / $2,066.69	Professional		$1,692.56	$1,733.12	$2,066.69
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 $214.54 / $299.47 / $403.38	Facility		$214.54	$299.47	$403.38
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $429.77	Facility	54	$183.20	$183.20	$429.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $210.38 / $291.75 / $599.61	Professional		$210.38	$291.75	$599.61
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $724.78 / $724.78 / $740.41	Professional		$724.78	$724.78	$740.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $239.58 / $329.42	Professional		$104.08	$239.58	$329.42
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 $170.69 / $223.92 / $498.57	Professional		$170.69	$223.92	$498.57