Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.45 / $2,940.00 / $16,850.00	Facility		$263.45	$2,940.00	$16,850.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $166.80 / $181.87 / $1,293.83	Facility	54	$166.80	$181.87	$1,293.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.82 / $271.08 / $1,164.91	Professional		$208.82	$271.08	$1,164.91
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 $258.82 / $334.11 / $683.01	Professional		$258.82	$334.11	$683.01
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 $191.88 / $274.12 / $592.83	Professional		$191.88	$274.12	$592.83
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 $245.73 / $332.49 / $688.57	Professional		$245.73	$332.49	$688.57
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $124.72 / $330.15 / $445.70	Professional		$124.72	$330.15	$445.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.48 / $379.67 / $662.47	Professional		$281.48	$379.67	$662.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,265.57 / $1,411.32	Facility		$55.00	$1,265.57	$1,411.32
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $885.90 / $987.92 / $987.92	Facility	54	$885.90	$987.92	$987.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,986.96 / $2,222.64 / $2,597.25	Professional		$1,986.96	$2,222.64	$2,597.25
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 $245.59 / $361.83 / $490.25	Facility		$245.59	$361.83	$490.25
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $322.54 / $322.54 / $552.46	Facility	54	$322.54	$322.54	$552.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $252.20 / $353.91 / $709.59	Professional		$252.20	$353.91	$709.59
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $841.66 / $841.66 / $922.20	Professional		$841.66	$841.66	$922.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $139.69 / $267.38 / $408.94	Professional		$139.69	$267.38	$408.94
United Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $1,506.00 / $5,830.00	Facility		$510.00	$1,506.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $218.16 / $280.80 / $614.33	Professional		$218.16	$280.80	$614.33