Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $480.25 / $4,085.57 / $15,877.00	Facility		$480.25	$4,085.57	$15,877.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $298.27 / $331.83 / $2,224.64	Facility	54	$298.27	$331.83	$2,224.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $373.29 / $485.88 / $2,208.34	Professional		$373.29	$485.88	$2,208.34
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 $495.43 / $649.01 / $1,236.14	Professional		$495.43	$649.01	$1,236.14
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 $383.79 / $540.91 / $1,215.51	Professional		$383.79	$540.91	$1,215.51
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 $446.26 / $581.08 / $1,190.68	Professional		$446.26	$581.08	$1,190.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $260.61 / $586.86 / $825.58	Professional		$260.61	$586.86	$825.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $463.76 / $628.63 / $1,064.67	Professional		$463.76	$628.63	$1,064.67
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,116.52 / $2,298.71 / $12,000.00	Facility		$2,116.52	$2,298.71	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,455.99 / $1,609.10 / $1,609.10	Facility	54	$1,455.99	$1,609.10	$1,609.10
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,262.96 / $3,741.04 / $4,364.78	Professional		$3,262.96	$3,741.04	$4,364.78
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 $506.63 / $624.00 / $831.69	Facility		$506.63	$624.00	$831.69
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $532.91 / $532.91 / $943.04	Facility	54	$532.91	$532.91	$943.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $453.08 / $616.37 / $1,209.92	Professional		$453.08	$616.37	$1,209.92
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,418.41 / $1,418.41 / $1,592.72	Professional		$1,418.41	$1,418.41	$1,592.72
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $364.85 / $492.98 / $679.00	Professional		$364.85	$492.98	$679.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,407.00 / $2,679.00 / $7,399.00	Facility		$1,407.00	$2,679.00	$7,399.00
United Facility/Professional Professional Modifier Low / Median / High Price $382.22 / $503.64 / $1,187.88	Professional		$382.22	$503.64	$1,187.88