Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,208.95 / $5,310.00 / $16,713.00	Facility		$1,208.95	$5,310.00	$16,713.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $313.55 / $338.04 / $2,104.60	Facility	54	$313.55	$338.04	$2,104.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $383.38 / $472.01 / $2,444.67	Professional		$383.38	$472.01	$2,444.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,597.00 / $9,381.00	Facility		$1,723.00	$4,597.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $509.84 / $638.53 / $1,268.89	Professional		$509.84	$638.53	$1,268.89
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,367.09	Facility		$66.00	$100.00	$5,367.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $351.65 / $510.26 / $1,146.69	Professional		$351.65	$510.26	$1,146.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,487.00 / $1,646.28 / $2,948.55	Facility		$1,487.00	$1,646.28	$2,948.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $452.43 / $585.26 / $1,268.92	Professional		$452.43	$585.26	$1,268.92
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $244.91 / $567.89 / $766.65	Professional		$244.91	$567.89	$766.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $461.90 / $637.99 / $1,129.08	Professional		$461.90	$637.99	$1,129.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,225.05 / $4,754.80 / $12,000.00	Facility		$2,225.05	$4,754.80	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $761.96 / $3,154.80 / $3,154.80	Facility	54	$761.96	$3,154.80	$3,154.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,446.80 / $3,514.08 / $4,101.45	Professional		$3,446.80	$3,514.08	$4,101.45
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 $478.30 / $599.94 / $831.02	Facility		$478.30	$599.94	$831.02
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $375.54 / $375.54 / $898.07	Facility	54	$375.54	$375.54	$898.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $460.59 / $616.89 / $1,242.17	Professional		$460.59	$616.89	$1,242.17
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,516.86 / $1,516.86 / $1,516.86	Professional		$1,516.86	$1,516.86	$1,516.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $254.71 / $416.35 / $630.42	Professional		$254.71	$416.35	$630.42
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $5,830.00	Facility		$587.00	$1,551.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $361.26 / $485.71 / $1,045.40	Professional		$361.26	$485.71	$1,045.40