Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.61 / $4,749.00 / $16,573.00	Facility		$336.61	$4,749.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $207.52 / $229.45 / $1,569.93	Facility	54	$207.52	$229.45	$1,569.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.92 / $305.93 / $1,164.10	Professional		$257.92	$305.93	$1,164.10
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 $322.00 / $414.30 / $832.41	Professional		$322.00	$414.30	$832.41
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 $237.58 / $331.10 / $733.00	Professional		$237.58	$331.10	$733.00
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 $299.72 / $397.01 / $843.23	Professional		$299.72	$397.01	$843.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $176.93 / $394.42 / $532.47	Professional		$176.93	$394.42	$532.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $328.38 / $443.93 / $782.81	Professional		$328.38	$443.93	$782.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,500.88 / $1,666.97 / $12,000.00	Facility		$1,500.88	$1,666.97	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,032.09 / $1,166.88 / $1,166.88	Facility	54	$1,032.09	$1,166.88	$1,166.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,323.04 / $2,561.19 / $2,977.43	Professional		$2,323.04	$2,561.19	$2,977.43
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 $290.52 / $426.17 / $579.04	Facility		$290.52	$426.17	$579.04
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $373.20 / $373.20 / $642.40	Facility	54	$373.20	$373.20	$642.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.14 / $425.80 / $860.24	Professional		$302.14	$425.80	$860.24
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,011.88 / $1,011.88 / $1,102.04	Professional		$1,011.88	$1,011.88	$1,102.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $198.16 / $349.07 / $479.97	Professional		$198.16	$349.07	$479.97
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 $258.12 / $342.03 / $758.47	Professional		$258.12	$342.03	$758.47