Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $4,436.00 / $16,125.00	Facility		$365.00	$4,436.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $177.50 / $198.63 / $1,373.33	Facility	54	$177.50	$198.63	$1,373.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.46 / $265.98 / $1,056.27	Professional		$220.46	$265.98	$1,056.27
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 $281.13 / $352.58 / $709.43	Professional		$281.13	$352.58	$709.43
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 $202.22 / $286.44 / $626.87	Professional		$202.22	$286.44	$626.87
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 $254.64 / $345.17 / $736.86	Professional		$254.64	$345.17	$736.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $154.54 / $344.65 / $465.28	Professional		$154.54	$344.65	$465.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.63 / $390.99 / $683.10	Professional		$286.63	$390.99	$683.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,309.00 / $1,455.50 / $12,000.00	Facility		$1,309.00	$1,455.50	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $900.74 / $1,018.85 / $1,018.85	Facility	54	$900.74	$1,018.85	$1,018.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,022.32 / $2,250.64 / $2,627.78	Professional		$2,022.32	$2,250.64	$2,627.78
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 $251.94 / $371.24 / $508.08	Facility		$251.94	$371.24	$508.08
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $566.60	Facility	54	$325.16	$325.16	$566.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $259.86 / $368.36 / $750.49	Professional		$259.86	$368.36	$750.49
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $873.66 / $873.66 / $962.62	Professional		$873.66	$873.66	$962.62
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $173.08 / $308.10 / $423.64	Professional		$173.08	$308.10	$423.64
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 $225.72 / $295.00 / $675.08	Professional		$225.72	$295.00	$675.08