Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $498.94 / $4,420.00 / $16,125.00	Facility		$498.94	$4,420.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $310.01 / $343.04 / $2,305.76	Facility	54	$310.01	$343.04	$2,305.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.58 / $457.38 / $2,369.48	Professional		$386.58	$457.38	$2,369.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,597.00 / $9,381.00	Facility		$1,723.00	$4,597.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $500.43 / $648.76 / $1,261.08	Professional		$500.43	$648.76	$1,261.08
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 $382.73 / $538.15 / $1,213.30	Professional		$382.73	$538.15	$1,213.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,487.00 / $1,646.28 / $2,948.55	Facility		$1,487.00	$1,646.28	$2,948.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.81 / $599.54 / $1,221.19	Professional		$457.81	$599.54	$1,221.19
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $269.17 / $611.30 / $853.73	Professional		$269.17	$611.30	$853.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $476.70 / $644.79 / $1,101.98	Professional		$476.70	$644.79	$1,101.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,180.00 / $2,379.28 / $12,000.00	Facility		$2,180.00	$2,379.28	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,496.25 / $1,665.50 / $1,665.50	Facility	54	$1,496.25	$1,665.50	$1,665.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,353.28 / $3,835.28 / $4,465.20	Professional		$3,353.28	$3,835.28	$4,465.20
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 $480.59 / $630.61 / $853.73	Facility		$480.59	$630.61	$853.73
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $545.19 / $545.19 / $972.59	Facility	54	$545.19	$545.19	$972.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $460.89 / $634.41 / $1,254.13	Professional		$460.89	$634.41	$1,254.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,470.22 / $1,470.22 / $1,638.52	Professional		$1,470.22	$1,470.22	$1,638.52
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $301.47 / $504.80 / $702.25	Professional		$301.47	$504.80	$702.25
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,533.00 / $5,830.00	Facility		$587.00	$1,533.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $391.96 / $516.02 / $1,132.85	Professional		$391.96	$516.02	$1,132.85