Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $892.38 / $6,767.00 / $17,380.00	Facility		$892.38	$6,767.00	$17,380.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $472.70 / $681.23 / $2,546.42	Professional		$472.70	$681.23	$2,546.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $473.30 / $473.30 / $584.30	Professional		$473.30	$473.30	$584.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $7,007.00 / $14,981.00	Facility		$2,456.00	$7,007.00	$14,981.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $506.93 / $692.69 / $1,393.77	Professional		$506.93	$692.69	$1,393.77
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $7,826.58	Facility		$66.90	$100.00	$7,826.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $732.66 / $1,508.11	Professional		$512.86	$732.66	$1,508.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $3,101.23 / $5,554.45	Facility		$2,277.00	$3,101.23	$5,554.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $542.07 / $793.17 / $1,464.93	Professional		$542.07	$793.17	$1,464.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $319.43 / $603.58 / $1,142.29	Professional		$319.43	$603.58	$1,142.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $476.31 / $748.48 / $1,293.78	Professional		$476.31	$748.48	$1,293.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,188.56 / $2,366.50 / $26,542.00	Facility		$2,188.56	$2,366.50	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $213.75 / $236.65 / $236.65	Facility	AS	$213.75	$236.65	$236.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,416.56 / $4,962.56 / $5,754.38	Professional		$3,416.56	$4,962.56	$5,754.38
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 $524.66 / $737.65 / $1,101.08	Facility		$524.66	$737.65	$1,101.08
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $261.33 / $261.33 / $261.33	Facility	80	$261.33	$261.33	$261.33
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $78.93 / $78.93 / $222.13	Facility	AS	$78.93	$78.93	$222.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $556.12 / $836.89 / $1,640.22	Professional		$556.12	$836.89	$1,640.22
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $3,841.00 / $3,841.00 / $3,841.00	Facility		$3,841.00	$3,841.00	$3,841.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,511.30 / $1,511.30 / $2,397.28	Professional		$1,511.30	$1,511.30	$2,397.28
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $443.24 / $604.25 / $940.31	Professional		$443.24	$604.25	$940.31
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,359.00 / $15,471.00	Facility		$3,523.00	$7,359.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $558.15 / $735.12 / $1,658.10	Professional		$558.15	$735.12	$1,658.10