Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $424.19 / $4,023.00 / $16,008.00	Facility		$424.19	$4,023.00	$16,008.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $265.80 / $291.44 / $1,964.50	Facility	54	$265.80	$291.44	$1,964.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.74 / $398.83 / $1,581.01	Professional		$341.74	$398.83	$1,581.01
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 $430.12 / $543.79 / $1,076.64	Professional		$430.12	$543.79	$1,076.64
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 $327.62 / $462.90 / $1,040.16	Professional		$327.62	$462.90	$1,040.16
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 $393.02 / $506.57 / $1,060.20	Professional		$393.02	$506.57	$1,060.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $220.77 / $474.91 / $641.13	Professional		$220.77	$474.91	$641.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $403.67 / $549.13 / $940.90	Professional		$403.67	$549.13	$940.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,858.84 / $2,031.48 / $12,000.00	Facility		$1,858.84	$2,031.48	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,275.83 / $1,422.04 / $1,422.04	Facility	54	$1,275.83	$1,422.04	$1,422.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,865.60 / $3,238.80 / $3,762.75	Professional		$2,865.60	$3,238.80	$3,762.75
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 $388.58 / $532.90 / $721.06	Facility		$388.58	$532.90	$721.06
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $820.34	Facility	54	$465.03	$465.03	$820.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $393.46 / $540.34 / $1,074.31	Professional		$393.46	$540.34	$1,074.31
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,262.78 / $1,262.78 / $1,396.22	Professional		$1,262.78	$1,262.78	$1,396.22
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $309.08 / $431.42 / $593.16	Professional		$309.08	$431.42	$593.16
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,523.00 / $5,830.00	Facility		$526.00	$1,523.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $336.28 / $439.56 / $1,061.78	Professional		$336.28	$439.56	$1,061.78