Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $471.20 / $4,063.00 / $16,008.00	Facility		$471.20	$4,063.00	$16,008.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $295.13 / $324.73 / $2,152.33	Facility	54	$295.13	$324.73	$2,152.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.54 / $432.97 / $1,378.83	Professional		$368.54	$432.97	$1,378.83
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 $480.92 / $630.32 / $1,211.91	Professional		$480.92	$630.32	$1,211.91
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 $369.09 / $522.74 / $1,169.08	Professional		$369.09	$522.74	$1,169.08
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 $435.42 / $562.98 / $1,163.21	Professional		$435.42	$562.98	$1,163.21
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $250.56 / $574.80 / $798.39	Professional		$250.56	$574.80	$798.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $447.64 / $609.87 / $1,039.26	Professional		$447.64	$609.87	$1,039.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,061.40 / $2,243.85 / $12,000.00	Facility		$2,061.40	$2,243.85	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,415.72 / $1,570.70 / $1,570.70	Facility	54	$1,415.72	$1,570.70	$1,570.70
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,173.92 / $3,606.48 / $4,200.30	Professional		$3,173.92	$3,606.48	$4,200.30
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 $480.00 / $618.91 / $805.02	Facility		$480.00	$618.91	$805.02
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $910.28	Facility	54	$517.01	$517.01	$910.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $440.41 / $599.15 / $1,171.05	Professional		$440.41	$599.15	$1,171.05
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,382.72 / $1,382.72 / $1,536.60	Professional		$1,382.72	$1,382.72	$1,536.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $350.78 / $474.62 / $656.68	Professional		$350.78	$474.62	$656.68
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,699.00 / $7,399.00	Facility		$1,371.00	$2,699.00	$7,399.00
United Facility/Professional Professional Modifier Low / Median / High Price $368.49 / $484.80 / $1,054.16	Professional		$368.49	$484.80	$1,054.16