Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $12,589.25 / $46,773.51	Facility		$4,786.30	$12,589.25	$46,773.51
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $9,772.37 / $21,379.62 / $21,379.62	Facility	22	$9,772.37	$21,379.62	$21,379.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,754.40 / $30,902.95 / $64,565.42	Facility	50	$5,754.40	$30,902.95	$64,565.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $6,918.31	Professional		$1,148.15	$1,778.28	$6,918.31
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $158.49 / $436.52 / $1,047.13	Professional	AS	$158.49	$436.52	$1,047.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $1,174.90 / $2,089.30	Professional		$229.09	$1,174.90	$2,089.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $11,748.98 / $22,387.21	Facility		$6,918.31	$11,748.98	$22,387.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,454.71 / $4,365.16	Professional		$1,659.59	$2,454.71	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $208.93 / $363.08	Professional	AS	$169.82	$208.93	$363.08
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $3,388.44 / $10,964.78	Facility		$63.10	$3,388.44	$10,964.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,041.74 / $3,801.89	Professional		$1,445.44	$2,041.74	$3,801.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,715.19 / $18,620.87 / $30,199.52	Facility		$10,715.19	$18,620.87	$30,199.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,737.80 / $3,548.13	Professional		$1,348.96	$1,737.80	$3,548.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,479.11 / $2,238.72	Professional		$1,318.26	$1,479.11	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,445.44 / $2,691.53	Professional		$1,071.52	$1,445.44	$2,691.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $20,892.96 / $25,118.86 / $53,703.18	Facility		$20,892.96	$25,118.86	$53,703.18
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $37,153.52 / $37,153.52 / $37,153.52	Facility	54	$37,153.52	$37,153.52	$37,153.52
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $33,884.42 / $33,884.42 / $33,884.42	Facility	62	$33,884.42	$33,884.42	$33,884.42
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Facility	AS	$5,370.32	$5,370.32	$5,370.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $13,489.63 / $13,489.63 / $13,489.63	Professional		$13,489.63	$13,489.63	$13,489.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Professional		$1,862.09	$1,862.09	$1,862.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $2,951.21	Facility		$1,258.93	$1,737.80	$2,951.21
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,778.28 / $3,467.37	Professional		$1,348.96	$1,778.28	$3,467.37
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Professional		$4,365.16	$4,365.16	$4,365.16
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $2,089.30 / $3,162.28	Professional		$1,174.90	$2,089.30	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $10,000.00 / $18,620.87 / $43,651.58	Facility		$10,000.00	$18,620.87	$43,651.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,445.44 / $2,884.03	Professional		$1,047.13	$1,445.44	$2,884.03