Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.19 / $4,749.00 / $16,573.00	Facility		$301.19	$4,749.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $173.39 / $190.03 / $1,262.58	Facility	54	$173.39	$190.03	$1,262.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $214.49 / $254.30 / $680.90	Professional		$214.49	$254.30	$680.90
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 $273.74 / $354.71 / $689.82	Professional		$273.74	$354.71	$689.82
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 $194.21 / $264.68 / $595.99	Professional		$194.21	$264.68	$595.99
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 $244.86 / $325.79 / $690.47	Professional		$244.86	$325.79	$690.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $220.16 / $335.62 / $453.09	Professional		$220.16	$335.62	$453.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $276.54 / $368.74 / $655.47	Professional		$276.54	$368.74	$655.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,562.20 / $1,588.00	Facility		$55.00	$1,562.20	$1,588.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $874.23 / $990.65 / $990.65	Facility	54	$874.23	$990.65	$990.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,963.28 / $2,084.23 / $2,435.33	Professional		$1,963.28	$2,084.23	$2,435.33
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 $254.19 / $357.37 / $482.83	Facility		$254.19	$357.37	$482.83
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $315.25 / $315.25 / $524.20	Facility	54	$315.25	$315.25	$524.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $248.33 / $344.58 / $713.78	Professional		$248.33	$344.58	$713.78
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $849.58 / $849.58 / $886.85	Professional		$849.58	$849.58	$886.85
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $256.86 / $320.45 / $412.81	Professional		$256.86	$320.45	$412.81
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 $208.17 / $274.04 / $588.72	Professional		$208.17	$274.04	$588.72