Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $493.83 / $3,747.00 / $15,877.00	Facility		$493.83	$3,747.00	$15,877.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $341.30 / $370.37 / $2,447.06	Facility	54	$341.30	$370.37	$2,447.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.43 / $500.57 / $1,392.35	Professional		$426.43	$500.57	$1,392.35
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 $554.95 / $709.70 / $1,389.73	Professional		$554.95	$709.70	$1,389.73
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,403.01	Facility		$66.00	$100.00	$5,403.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $407.49 / $577.79 / $1,312.51	Professional		$407.49	$577.79	$1,312.51
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 $497.47 / $639.70 / $1,315.83	Professional		$497.47	$639.70	$1,315.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $272.52 / $649.58 / $887.07	Professional		$272.52	$649.58	$887.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $504.27 / $679.11 / $1,194.49	Professional		$504.27	$679.11	$1,194.49
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,344.88 / $2,543.71 / $12,000.00	Facility		$2,344.88	$2,543.71	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,610.71 / $1,780.60 / $1,780.60	Facility	54	$1,610.71	$1,780.60	$1,780.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,609.44 / $4,043.60 / $4,707.14	Professional		$3,609.44	$4,043.60	$4,707.14
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 $545.37 / $674.28 / $893.64	Facility		$545.37	$674.28	$893.64
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $1,031.70	Facility	54	$589.41	$589.41	$1,031.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $502.91 / $683.82 / $1,355.24	Professional		$502.91	$683.82	$1,355.24
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,605.52 / $1,605.52 / $1,753.38	Professional		$1,605.52	$1,605.52	$1,753.38
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $381.53 / $536.30 / $729.53	Professional		$381.53	$536.30	$729.53
United Facility/Professional Facility Modifier Low / Median / High Price $2,048.00 / $4,060.00 / $9,072.00	Facility		$2,048.00	$4,060.00	$9,072.00
United Facility/Professional Professional Modifier Low / Median / High Price $417.38 / $554.58 / $1,188.96	Professional		$417.38	$554.58	$1,188.96