Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.30 / $4,420.00 / $16,125.00	Facility		$263.30	$4,420.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $159.88 / $178.38 / $1,247.04	Facility	54	$159.88	$178.38	$1,247.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.80 / $261.62 / $836.62	Professional		$207.80	$261.62	$836.62
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 $250.81 / $328.72 / $632.04	Professional		$250.81	$328.72	$632.04
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 $178.39 / $251.51 / $557.28	Professional		$178.39	$251.51	$557.28
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 $230.34 / $316.20 / $670.24	Professional		$230.34	$316.20	$670.24
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $142.50 / $319.25 / $430.99	Professional		$142.50	$319.25	$430.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.42 / $357.24 / $632.50	Professional		$263.42	$357.24	$632.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,193.48 / $1,340.88	Facility		$55.00	$1,193.48	$1,340.88
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $824.44 / $938.62 / $938.62	Facility	54	$824.44	$938.62	$938.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,851.68 / $2,044.16 / $2,390.48	Professional		$1,851.68	$2,044.16	$2,390.48
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 $266.75 / $342.95 / $463.43	Facility		$266.75	$342.95	$463.43
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $296.41 / $296.41 / $509.42	Facility	54	$296.41	$296.41	$509.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $238.06 / $333.68 / $680.22	Professional		$238.06	$333.68	$680.22
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $791.95 / $791.95 / $868.89	Professional		$791.95	$791.95	$868.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $159.60 / $283.18 / $389.37	Professional		$159.60	$283.18	$389.37
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 $203.54 / $264.94 / $664.05	Professional		$203.54	$264.94	$664.05