Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,749.00 / $16,573.00	Facility		$344.00	$4,749.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $150.59 / $164.62 / $1,081.73	Facility	54	$150.59	$164.62	$1,081.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.28 / $219.90 / $789.69	Professional		$183.28	$219.90	$789.69
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 $229.30 / $300.19 / $604.03	Professional		$229.30	$300.19	$604.03
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 $162.76 / $222.89 / $505.02	Professional		$162.76	$222.89	$505.02
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 $208.55 / $282.60 / $604.34	Professional		$208.55	$282.60	$604.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $192.11 / $303.08 / $409.16	Professional		$192.11	$303.08	$409.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $242.72 / $327.82 / $593.32	Professional		$242.72	$327.82	$593.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,416.85 / $1,447.20 / $12,000.00	Facility		$1,416.85	$1,447.20	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $793.71 / $896.72 / $896.72	Facility	54	$793.71	$896.72	$896.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,779.28 / $1,833.36 / $2,133.30	Professional		$1,779.28	$1,833.36	$2,133.30
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 $225.90 / $315.13 / $418.87	Facility		$225.90	$315.13	$418.87
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $461.89	Facility	54	$286.50	$286.50	$461.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.53 / $294.45 / $627.30	Professional		$213.53	$294.45	$627.30
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $760.83 / $760.83 / $764.44	Professional		$760.83	$760.83	$764.44
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $244.80 / $277.50 / $345.79	Professional		$244.80	$277.50	$345.79
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 $179.07 / $233.45 / $578.53	Professional		$179.07	$233.45	$578.53