Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $4,702.00 / $16,125.00	Facility		$365.00	$4,702.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $199.73 / $221.13 / $1,517.83	Facility	54	$199.73	$221.13	$1,517.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.03 / $294.83 / $892.68	Professional		$248.03	$294.83	$892.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $296.50 / $296.50 / $296.50	Professional		$296.50	$296.50	$296.50
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 $316.39 / $414.67 / $797.30	Professional		$316.39	$414.67	$797.30
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 $227.37 / $319.16 / $704.99	Professional		$227.37	$319.16	$704.99
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 $287.87 / $383.54 / $823.23	Professional		$287.87	$383.54	$823.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $176.52 / $422.23 / $521.05	Professional		$176.52	$422.23	$521.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $321.08 / $433.44 / $765.42	Professional		$321.08	$433.44	$765.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,467.84 / $1,630.87 / $12,000.00	Facility		$1,467.84	$1,630.87	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,009.86 / $1,141.60 / $1,141.60	Facility	54	$1,009.86	$1,141.60	$1,141.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,267.28 / $2,500.16 / $2,916.08	Professional		$2,267.28	$2,500.16	$2,916.08
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 $293.35 / $416.10 / $566.51	Facility		$293.35	$416.10	$566.51
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $629.54	Facility	54	$364.69	$364.69	$629.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $290.54 / $410.97 / $837.08	Professional		$290.54	$410.97	$837.08
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $979.72 / $979.72 / $1,065.07	Professional		$979.72	$979.72	$1,065.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $247.13 / $350.75 / $469.03	Professional		$247.13	$350.75	$469.03
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 $249.75 / $329.17 / $750.18	Professional		$249.75	$329.17	$750.18