Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.00 / $4,941.00 / $16,196.79	Facility		$462.00	$4,941.00	$16,196.79
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $199.56 / $220.43 / $1,534.26	Facility	54	$199.56	$220.43	$1,534.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.89 / $300.36 / $1,087.50	Professional		$247.89	$300.36	$1,087.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $790.16 / $790.16 / $790.16	Professional		$790.16	$790.16	$790.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,759.00 / $4,464.00 / $8,976.00	Facility		$1,759.00	$4,464.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.83 / $396.81 / $798.44	Professional		$316.83	$396.81	$798.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,919.63	Facility		$66.00	$100.00	$6,919.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $239.70 / $329.57 / $752.72	Professional		$239.70	$329.57	$752.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.20 / $253.65 / $1,992.00	Facility		$253.20	$253.65	$1,992.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.06 / $391.31 / $823.21	Professional		$294.06	$391.31	$823.21
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $183.17 / $380.57 / $513.77	Professional		$183.17	$380.57	$513.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.64 / $433.40 / $755.18	Professional		$317.64	$433.40	$755.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,450.88 / $1,609.06 / $16,394.00	Facility		$1,450.88	$1,609.06	$16,394.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $997.15 / $1,126.33 / $1,126.33	Facility	54	$997.15	$1,126.33	$1,126.33
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,238.40 / $2,533.04 / $2,947.43	Professional		$2,238.40	$2,533.04	$2,947.43
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 $293.70 / $418.76 / $567.23	Facility		$293.70	$418.76	$567.23
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $360.25 / $360.25 / $641.11	Facility	54	$360.25	$360.25	$641.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $298.10 / $417.06 / $838.24	Professional		$298.10	$417.06	$838.24
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $969.51 / $969.51 / $1,075.30	Professional		$969.51	$969.51	$1,075.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $205.15 / $345.28 / $474.76	Professional		$205.15	$345.28	$474.76
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 $251.91 / $326.55 / $740.60	Professional		$251.91	$326.55	$740.60