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 $204.58 / $229.42 / $1,578.56	Facility	54	$204.58	$229.42	$1,578.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.93 / $321.58 / $827.89	Professional		$253.93	$321.58	$827.89
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 $324.23 / $421.27 / $817.07	Professional		$324.23	$421.27	$817.07
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 $235.64 / $328.85 / $729.36	Professional		$235.64	$328.85	$729.36
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 $299.18 / $400.05 / $845.72	Professional		$299.18	$400.05	$845.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $337.75 / $432.45 / $532.41	Professional		$337.75	$432.45	$532.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.88 / $446.00 / $778.44	Professional		$327.88	$446.00	$778.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,492.48 / $1,658.32 / $12,000.00	Facility		$1,492.48	$1,658.32	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,024.70 / $1,160.82 / $1,160.82	Facility	54	$1,024.70	$1,160.82	$1,160.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,302.71 / $2,579.60 / $3,001.65	Professional		$2,302.71	$2,579.60	$3,001.65
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 $295.13 / $429.70 / $582.41	Facility		$295.13	$429.70	$582.41
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $648.82	Facility	54	$369.72	$369.72	$648.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $300.29 / $423.83 / $860.55	Professional		$300.29	$423.83	$860.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $999.56 / $999.56 / $1,104.15	Professional		$999.56	$999.56	$1,104.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $436.68 / $633.28	Professional		$340.31	$436.68	$633.28
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 $258.44 / $339.58 / $760.83	Professional		$258.44	$339.58	$760.83