Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,397.00 / $16,125.00	Facility		$344.00	$4,397.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $161.61 / $178.26 / $1,241.25	Facility	54	$161.61	$178.26	$1,241.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.07 / $257.92 / $942.68	Professional		$211.07	$257.92	$942.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.17 / $289.37 / $595.45	Professional		$266.17	$289.37	$595.45
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 $254.12 / $320.73 / $640.38	Professional		$254.12	$320.73	$640.38
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $178.83 / $255.47 / $555.70	Professional		$178.83	$255.47	$555.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $253.20 / $453.49	Facility		$56.00	$253.20	$453.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.28 / $316.25 / $672.70	Professional		$233.28	$316.25	$672.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $149.31 / $321.38 / $433.86	Professional		$149.31	$321.38	$433.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $265.87 / $356.48 / $634.59	Professional		$265.87	$356.48	$634.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,207.11 / $1,352.66	Facility		$55.00	$1,207.11	$1,352.66
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $833.97 / $946.86 / $946.86	Facility	54	$833.97	$946.86	$946.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $2,035.92 / $2,387.85	Professional		$1,870.00	$2,035.92	$2,387.85
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 $238.38 / $341.72 / $466.00	Facility		$238.38	$341.72	$466.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $509.42	Facility	54	$300.10	$300.10	$509.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $237.76 / $337.48 / $679.99	Professional		$237.76	$337.48	$679.99
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $800.66 / $800.66 / $866.78	Professional		$800.66	$800.66	$866.78
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $167.23 / $280.77 / $386.07	Professional		$167.23	$280.77	$386.07
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,506.00 / $5,830.00	Facility		$526.00	$1,506.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.77 / $265.30 / $604.29	Professional		$202.77	$265.30	$604.29