Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.42 / $6,695.00 / $18,681.00	Facility		$293.42	$6,695.00	$18,681.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $201.78 / $220.07 / $1,525.19	Facility	54	$201.78	$220.07	$1,525.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.04 / $316.95 / $1,139.47	Professional		$251.04	$316.95	$1,139.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $329.09 / $329.09 / $329.09	Professional		$329.09	$329.09	$329.09
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 $310.88 / $403.74 / $806.12	Professional		$310.88	$403.74	$806.12
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 $221.65 / $316.63 / $695.87	Professional		$221.65	$316.63	$695.87
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 $289.32 / $387.46 / $827.64	Professional		$289.32	$387.46	$827.64
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $310.87 / $424.30 / $526.96	Professional		$310.87	$424.30	$526.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $325.86 / $437.04 / $774.47	Professional		$325.86	$437.04	$774.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,492.40 / $1,653.43	Facility		$55.00	$1,492.40	$1,653.43
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,026.83 / $1,157.40 / $1,157.40	Facility	54	$1,026.83	$1,157.40	$1,157.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,305.84 / $2,532.56 / $2,946.08	Professional		$2,305.84	$2,532.56	$2,946.08
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 $331.00 / $429.25 / $586.83	Facility		$331.00	$429.25	$586.83
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $371.55 / $371.55 / $639.17	Facility	54	$371.55	$371.55	$639.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $298.74 / $409.63 / $844.06	Professional		$298.74	$409.63	$844.06
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $996.34 / $996.34 / $1,074.48	Professional		$996.34	$996.34	$1,074.48
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $339.24 / $433.51 / $559.57	Professional		$339.24	$433.51	$559.57
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 $252.57 / $327.08 / $739.13	Professional		$252.57	$327.08	$739.13