Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.45 / $5,165.00 / $16,713.00	Facility		$464.45	$5,165.00	$16,713.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $291.98 / $319.45 / $2,160.51	Facility	54	$291.98	$319.45	$2,160.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.38 / $444.22 / $1,930.84	Professional		$374.38	$444.22	$1,930.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,400.00	Facility		$2,137.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $473.38 / $594.29 / $1,186.57	Professional		$473.38	$594.29	$1,186.57
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,919.63	Facility		$66.00	$100.00	$6,919.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $358.37 / $508.36 / $1,142.40	Professional		$358.37	$508.36	$1,142.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,646.28 / $1,649.19 / $2,948.55	Facility		$1,646.28	$1,649.19	$2,948.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.86 / $560.39 / $1,147.92	Professional		$430.86	$560.39	$1,147.92
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $215.93 / $578.74 / $795.18	Professional		$215.93	$578.74	$795.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $447.21 / $605.87 / $1,042.65	Professional		$447.21	$605.87	$1,042.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,521.40 / $2,576.15 / $16,394.00	Facility		$2,521.40	$2,576.15	$16,394.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,414.67 / $1,575.82 / $1,575.82	Facility	54	$1,414.67	$1,575.82	$1,575.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,170.80 / $3,572.56 / $4,162.28	Professional		$3,170.80	$3,572.56	$4,162.28
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 $452.36 / $587.67 / $801.07	Facility		$452.36	$587.67	$801.07
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $515.25 / $515.25 / $907.07	Facility	54	$515.25	$515.25	$907.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $430.97 / $594.42 / $1,174.64	Professional		$430.97	$594.42	$1,174.64
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,392.91 / $1,392.91 / $1,535.96	Professional		$1,392.91	$1,392.91	$1,535.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $302.31 / $475.69 / $654.07	Professional		$302.31	$475.69	$654.07
United Facility/Professional Facility Modifier Low / Median / High Price $3,459.00 / $7,352.00 / $14,743.00	Facility		$3,459.00	$7,352.00	$14,743.00
United Facility/Professional Professional Modifier Low / Median / High Price $365.51 / $474.60 / $1,027.02	Professional		$365.51	$474.60	$1,027.02