Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $519.71 / $4,848.00 / $16,573.00	Facility		$519.71	$4,848.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $337.19 / $363.60 / $2,395.33	Facility	54	$337.19	$363.60	$2,395.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.61 / $491.32 / $2,025.73	Professional		$422.61	$491.32	$2,025.73
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 $522.90 / $692.15 / $1,376.05	Professional		$522.90	$692.15	$1,376.05
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 $399.85 / $550.09 / $1,252.52	Professional		$399.85	$550.09	$1,252.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.20 / $253.65 / $1,487.00	Facility		$253.20	$253.65	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.03 / $631.41 / $1,323.68	Professional		$487.03	$631.41	$1,323.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $257.26 / $644.70 / $815.81	Professional		$257.26	$644.70	$815.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $509.54 / $679.86 / $1,202.56	Professional		$509.54	$679.86	$1,202.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,920.45 / $2,977.90 / $12,000.00	Facility		$2,920.45	$2,977.90	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,639.31 / $1,817.51 / $1,817.51	Facility	54	$1,639.31	$1,817.51	$1,817.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,674.72 / $3,960.88 / $4,621.58	Professional		$3,674.72	$3,960.88	$4,621.58
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 $538.42 / $662.95 / $878.45	Facility		$538.42	$662.95	$878.45
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $598.88 / $598.88 / $1,011.78	Facility	54	$598.88	$598.88	$1,011.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $495.17 / $669.90 / $1,348.65	Professional		$495.17	$669.90	$1,348.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,621.87 / $1,621.87 / $1,716.84	Professional		$1,621.87	$1,621.87	$1,716.84
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $360.16 / $548.87 / $715.77	Professional		$360.16	$548.87	$715.77
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $6,323.00	Facility		$548.00	$1,533.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $407.43 / $543.24 / $1,176.59	Professional		$407.43	$543.24	$1,176.59