Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $873.00 / $4,976.00 / $16,210.00	Facility		$873.00	$4,976.00	$16,210.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.95 / $534.59 / $2,018.84	Professional		$318.95	$534.59	$2,018.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.25 / $315.25 / $315.25	Professional		$315.25	$315.25	$315.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,400.00	Facility		$2,137.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.27 / $495.10 / $1,264.75	Professional		$392.27	$495.10	$1,264.75
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $6,539.15	Facility		$66.90	$100.00	$6,539.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $376.41 / $647.96 / $1,189.78	Professional		$376.41	$647.96	$1,189.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,390.96 / $1,393.42 / $2,491.26	Facility		$1,390.96	$1,393.42	$2,491.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.37 / $608.90 / $1,123.10	Professional		$361.37	$608.90	$1,123.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $177.96 / $408.43 / $936.81	Professional		$177.96	$408.43	$936.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $350.28 / $601.89 / $1,050.81	Professional		$350.28	$601.89	$1,050.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,587.64 / $1,745.29 / $16,394.00	Facility		$1,587.64	$1,745.29	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,460.88 / $3,944.88 / $4,672.43	Professional		$2,460.88	$3,944.88	$4,672.43
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 $342.68 / $570.19 / $919.88	Facility		$342.68	$570.19	$919.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $365.70 / $647.83 / $1,201.70	Professional		$365.70	$647.83	$1,201.70
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $2,614.00 / $2,614.00 / $2,614.00	Facility		$2,614.00	$2,614.00	$2,614.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,084.49 / $1,084.49 / $1,773.33	Professional		$1,084.49	$1,084.49	$1,773.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $199.31 / $358.14 / $771.10	Professional		$199.31	$358.14	$771.10
United Facility/Professional Facility Modifier Low / Median / High Price $2,090.00 / $4,060.00 / $9,131.00	Facility		$2,090.00	$4,060.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $415.57 / $583.21 / $1,345.49	Professional		$415.57	$583.21	$1,345.49