Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,848.00 / $16,573.00	Facility		$344.00	$4,848.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $187.72 / $208.07 / $1,447.95	Facility	54	$187.72	$208.07	$1,447.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.84 / $302.42 / $847.26	Professional		$242.84	$302.42	$847.26
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 $296.48 / $371.32 / $747.15	Professional		$296.48	$371.32	$747.15
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 $211.02 / $294.11 / $655.34	Professional		$211.02	$294.11	$655.34
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 $267.80 / $363.22 / $778.80	Professional		$267.80	$363.22	$778.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $130.37 / $366.85 / $495.25	Professional		$130.37	$366.85	$495.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $304.63 / $412.65 / $726.52	Professional		$304.63	$412.65	$726.52
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,390.80 / $1,547.88 / $12,000.00	Facility		$1,390.80	$1,547.88	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $956.89 / $1,083.52 / $1,083.52	Facility	54	$956.89	$1,083.52	$1,083.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,149.36 / $2,375.12 / $2,771.03	Professional		$2,149.36	$2,375.12	$2,771.03
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 $262.95 / $395.69 / $537.11	Facility		$262.95	$395.69	$537.11
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $345.26 / $345.26 / $599.36	Facility	54	$345.26	$345.26	$599.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $268.87 / $387.65 / $792.11	Professional		$268.87	$387.65	$792.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $927.70 / $927.70 / $1,014.25	Professional		$927.70	$927.70	$1,014.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $146.01 / $325.30 / $447.29	Professional		$146.01	$325.30	$447.29
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 $237.60 / $309.60 / $698.72	Professional		$237.60	$309.60	$698.72