Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,820.00 / $6,640.00 / $17,701.00	Facility		$1,820.00	$6,640.00	$17,701.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $613.02 / $737.11 / $3,852.43	Professional		$613.02	$737.11	$3,852.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.32 / $235.32 / $235.32	Professional		$235.32	$235.32	$235.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $7,007.00 / $14,981.00	Facility		$2,456.00	$7,007.00	$14,981.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $824.65 / $1,040.81 / $2,072.71	Professional		$824.65	$1,040.81	$2,072.71
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,392.69	Facility		$66.00	$100.00	$8,392.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $581.62 / $835.84 / $1,898.42	Professional		$581.62	$835.84	$1,898.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $6,894.76 / $12,348.83	Facility		$2,277.00	$6,894.76	$12,348.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $735.30 / $926.57 / $1,999.34	Professional		$735.30	$926.57	$1,999.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $505.96 / $863.63 / $1,165.90	Professional		$505.96	$863.63	$1,165.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $699.80 / $968.50 / $1,736.04	Professional		$699.80	$968.50	$1,736.04
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,775.88 / $19,913.50 / $26,542.00	Facility		$2,775.88	$19,913.50	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,359.28 / $5,464.88 / $6,388.88	Professional		$5,359.28	$5,464.88	$6,388.88
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 $775.63 / $960.43 / $1,302.03	Facility		$775.63	$960.43	$1,302.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $736.25 / $975.75 / $1,968.61	Professional		$736.25	$975.75	$1,968.61
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,390.37 / $2,390.37 / $2,390.37	Professional		$2,390.37	$2,390.37	$2,390.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $657.74 / $784.14 / $958.40	Professional		$657.74	$784.14	$958.40
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,384.00 / $15,471.00	Facility		$3,523.00	$7,384.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $575.39 / $751.96 / $1,631.96	Professional		$575.39	$751.96	$1,631.96