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 / $16,713.00	Facility		$344.00	$4,848.00	$16,713.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $157.50 / $172.52 / $1,122.33	Facility	54	$157.50	$172.52	$1,122.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.06 / $224.89 / $726.28	Professional		$191.06	$224.89	$726.28
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 $237.77 / $316.32 / $641.90	Professional		$237.77	$316.32	$641.90
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 $170.81 / $244.01 / $560.23	Professional		$170.81	$244.01	$560.23
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 $224.78 / $295.89 / $620.71	Professional		$224.78	$295.89	$620.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $95.79 / $302.62 / $408.54	Professional		$95.79	$302.62	$408.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $249.97 / $331.81 / $599.25	Professional		$249.97	$331.81	$599.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,373.52 / $2,000.00 / $12,000.00	Facility		$1,373.52	$2,000.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $395.16 / $792.63 / $895.43	Facility	54	$395.16	$792.63	$895.43
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,776.88 / $1,838.88 / $2,189.85	Professional		$1,776.88	$1,838.88	$2,189.85
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 $220.28 / $317.12 / $427.92	Facility		$220.28	$317.12	$427.92
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $192.34 / $192.34 / $454.18	Facility	54	$192.34	$192.34	$454.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $226.93 / $311.98 / $635.24	Professional		$226.93	$311.98	$635.24
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $766.85 / $766.85 / $790.89	Professional		$766.85	$766.85	$790.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $107.28 / $254.09 / $349.37	Professional		$107.28	$254.09	$349.37
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 $180.63 / $236.67 / $527.41	Professional		$180.63	$236.67	$527.41