Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $355.34 / $4,848.00 / $16,573.00	Facility		$355.34	$4,848.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $218.87 / $242.39 / $1,684.79	Facility	54	$218.87	$242.39	$1,684.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.16 / $324.43 / $852.54	Professional		$283.16	$324.43	$852.54
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 $343.47 / $435.18 / $875.62	Professional		$343.47	$435.18	$875.62
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 $247.52 / $347.20 / $769.15	Professional		$247.52	$347.20	$769.15
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 $312.25 / $424.74 / $910.11	Professional		$312.25	$424.74	$910.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $176.90 / $427.54 / $577.17	Professional		$176.90	$427.54	$577.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.98 / $482.01 / $837.19	Professional		$355.98	$482.01	$837.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,632.24 / $1,807.57 / $12,000.00	Facility		$1,632.24	$1,807.57	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,120.06 / $1,265.30 / $1,265.30	Facility	54	$1,120.06	$1,265.30	$1,265.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,514.96 / $2,784.64 / $3,243.45	Professional		$2,514.96	$2,784.64	$3,243.45
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 $307.14 / $460.86 / $625.94	Facility		$307.14	$460.86	$625.94
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $699.58	Facility	54	$404.69	$404.69	$699.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $315.64 / $451.01 / $923.60	Professional		$315.64	$451.01	$923.60
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,084.58 / $1,084.58 / $1,183.15	Professional		$1,084.58	$1,084.58	$1,183.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $198.13 / $379.14 / $521.30	Professional		$198.13	$379.14	$521.30
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 $277.56 / $359.80 / $785.40	Professional		$277.56	$359.80	$785.40