Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,466.84 / $12,589.25 / $46,773.51	Facility		$4,466.84	$12,589.25	$46,773.51
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,090.30 / $3,090.30 / $9,772.37	Facility	22	$3,090.30	$3,090.30	$9,772.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,912.51 / $27,542.29 / $48,977.88	Facility	50	$8,912.51	$27,542.29	$48,977.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,737.80 / $7,762.47	Professional		$1,148.15	$1,737.80	$7,762.47
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $380.19 / $977.24	Professional	AS	$169.82	$380.19	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $1,348.96 / $2,238.72	Professional		$416.87	$1,348.96	$2,238.72
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $281.84 / $281.84 / $281.84	Professional	AS	$281.84	$281.84	$281.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,220.18 / $16,982.44 / $35,481.34	Facility		$11,220.18	$16,982.44	$35,481.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,570.40 / $4,570.88	Professional		$1,698.24	$2,570.40	$4,570.88
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $173.78 / $204.17 / $389.05	Professional	AS	$173.78	$204.17	$389.05
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $3,388.44 / $10,964.78	Facility		$64.57	$3,388.44	$10,964.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,137.96 / $3,981.07	Professional		$1,548.82	$2,137.96	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18,197.01 / $28,840.32 / $30,199.52	Facility		$18,197.01	$28,840.32	$30,199.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,819.70 / $3,548.13	Professional		$1,380.38	$1,819.70	$3,548.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,479.11 / $2,238.72	Professional		$1,288.25	$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 $19,054.61 / $33,884.42 / $52,480.75	Facility		$19,054.61	$33,884.42	$52,480.75
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 AS Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility	AS	$5,248.07	$5,248.07	$5,248.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,220.18 / $11,220.18 / $11,220.18	Professional		$11,220.18	$11,220.18	$11,220.18
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 $1,288.25 / $1,778.28 / $3,019.95	Facility		$1,288.25	$1,778.28	$3,019.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,819.70 / $3,388.44	Professional		$1,380.38	$1,819.70	$3,388.44
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 / $1,513.56 / $2,951.21	Professional		$1,047.13	$1,513.56	$2,951.21