Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $4,420.00 / $16,125.00	Facility		$365.00	$4,420.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $205.42 / $224.69 / $1,556.23	Facility	54	$205.42	$224.69	$1,556.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.20 / $314.74 / $999.62	Professional		$267.20	$314.74	$999.62
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 $325.35 / $411.08 / $820.79	Professional		$325.35	$411.08	$820.79
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 $233.86 / $324.66 / $722.39	Professional		$233.86	$324.66	$722.39
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 $295.52 / $396.92 / $841.89	Professional		$295.52	$396.92	$841.89
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $409.81 / $553.24	Professional		$137.72	$409.81	$553.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $339.22 / $453.55 / $799.11	Professional		$339.22	$453.55	$799.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,901.20 / $1,931.40	Facility		$55.00	$1,901.20	$1,931.40
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,063.92 / $1,207.74 / $1,207.74	Facility	54	$1,063.92	$1,207.74	$1,207.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,388.16 / $2,559.44 / $2,993.40	Professional		$2,388.16	$2,559.44	$2,993.40
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 $297.23 / $433.69 / $591.66	Facility		$297.23	$433.69	$591.66
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $383.12 / $383.12 / $644.97	Facility	54	$383.12	$383.12	$644.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $307.55 / $423.22 / $867.35	Professional		$307.55	$423.22	$867.35
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,025.59 / $1,025.59 / $1,089.32	Professional		$1,025.59	$1,025.59	$1,089.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $154.26 / $351.48 / $483.29	Professional		$154.26	$351.48	$483.29
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 $255.15 / $334.18 / $730.02	Professional		$255.15	$334.18	$730.02