Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.95 / $3,682.32 / $15,572.00	Facility		$375.95	$3,682.32	$15,572.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $180.10 / $199.65 / $1,582.15	Facility	54	$180.10	$199.65	$1,582.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.12 / $324.50 / $1,261.00	Professional		$240.12	$324.50	$1,261.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $174.88 / $249.08 / $1,264.75	Professional	54	$174.88	$249.08	$1,264.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $305.82 / $333.14 / $824.51	Professional		$305.82	$333.14	$824.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,694.00 / $11,233.00	Facility		$2,137.00	$5,694.00	$11,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.72 / $388.36 / $730.87	Professional		$285.72	$388.36	$730.87
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $434.52 / $539.16 / $672.18	Professional	50	$434.52	$539.16	$672.18
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 $202.67 / $289.52 / $634.38	Professional		$202.67	$289.52	$634.38
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 $269.35 / $392.26 / $848.01	Professional		$269.35	$392.26	$848.01
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $157.38 / $427.37 / $576.95	Professional		$157.38	$427.37	$576.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $348.80 / $465.61 / $806.10	Professional		$348.80	$465.61	$806.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,588.76 / $1,788.33	Facility		$55.00	$1,588.76	$1,788.33
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,094.65 / $1,251.83 / $1,251.83	Facility	54	$1,094.65	$1,251.83	$1,251.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,459.67 / $2,607.36 / $3,042.60	Professional		$2,459.67	$2,607.36	$3,042.60
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 $312.68 / $437.23 / $604.21	Facility		$312.68	$437.23	$604.21
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $654.61	Facility	54	$392.49	$392.49	$654.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $273.97 / $412.30 / $883.12	Professional		$273.97	$412.30	$883.12
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $490.72 / $523.04 / $2,352,000.00	Professional	54	$490.72	$523.04	$2,352,000.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,046.32 / $1,046.32 / $1,100.41	Professional		$1,046.32	$1,046.32	$1,100.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $176.27 / $361.65 / $497.27	Professional		$176.27	$361.65	$497.27
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,523.00 / $5,830.00	Facility		$526.00	$1,523.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $247.88 / $323.33 / $737.22	Professional		$247.88	$323.33	$737.22