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 $193.54 / $217.06 / $1,538.30	Facility	54	$193.54	$217.06	$1,538.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.80 / $302.27 / $1,280.83	Professional		$240.80	$302.27	$1,280.83
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 $307.73 / $403.33 / $775.48	Professional		$307.73	$403.33	$775.48
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 $226.34 / $314.00 / $701.07	Professional		$226.34	$314.00	$701.07
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 $284.62 / $383.10 / $823.07	Professional		$284.62	$383.10	$823.07
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $182.97 / $375.09 / $514.55	Professional		$182.97	$375.09	$514.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.05 / $433.02 / $745.36	Professional		$317.05	$433.02	$745.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,435.24 / $1,587.97 / $12,000.00	Facility		$1,435.24	$1,587.97	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $985.49 / $1,111.58 / $1,111.58	Facility	54	$985.49	$1,111.58	$1,111.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,212.96 / $2,543.67 / $2,957.78	Professional		$2,212.96	$2,543.67	$2,957.78
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 $293.18 / $413.62 / $566.96	Facility		$293.18	$413.62	$566.96
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $356.43 / $356.43 / $639.83	Facility	54	$356.43	$356.43	$639.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $290.26 / $409.83 / $830.47	Professional		$290.26	$409.83	$830.47
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $958.49 / $958.49 / $1,078.70	Professional		$958.49	$958.49	$1,078.70
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $204.93 / $340.84 / $476.32	Professional		$204.93	$340.84	$476.32
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 $252.72 / $327.60 / $716.08	Professional		$252.72	$327.60	$716.08