Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,008.45 / $6,229.00 / $16,210.00	Facility		$1,008.45	$6,229.00	$16,210.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $525.44 / $729.75 / $1,902.35	Professional		$525.44	$729.75	$1,902.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $420.09 / $420.09 / $589.76	Professional		$420.09	$420.09	$589.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,944.00 / $13,012.00	Facility		$2,143.00	$5,944.00	$13,012.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $603.29 / $790.72 / $1,520.29	Professional		$603.29	$790.72	$1,520.29
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $7,900.00	Facility		$66.90	$100.00	$7,900.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $550.21 / $786.01 / $1,617.92	Professional		$550.21	$786.01	$1,617.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,992.00 / $3,101.23 / $5,554.45	Facility		$1,992.00	$3,101.23	$5,554.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $576.02 / $812.06 / $1,501.33	Professional		$576.02	$812.06	$1,501.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $295.23 / $637.35 / $1,159.57	Professional		$295.23	$637.35	$1,159.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.61 / $765.34 / $1,331.12	Professional		$501.61	$765.34	$1,331.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,308.64 / $2,495.84 / $16,394.00	Facility		$2,308.64	$2,495.84	$16,394.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $224.95 / $249.58 / $249.58	Facility	AS	$224.95	$249.58	$249.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,800.00 / $5,066.00 / $5,830.58	Professional		$3,800.00	$5,066.00	$5,830.58
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 $592.52 / $792.47 / $1,134.53	Facility		$592.52	$792.47	$1,134.53
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $263.51 / $263.51 / $263.51	Facility	80	$263.51	$263.51	$263.51
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $83.17 / $83.17 / $223.99	Facility	AS	$83.17	$83.17	$223.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $583.29 / $859.76 / $1,660.75	Professional		$583.29	$859.76	$1,660.75
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $5,962.00 / $5,962.00 / $5,962.00	Facility		$5,962.00	$5,962.00	$5,962.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,597.27 / $1,597.27 / $2,433.96	Professional		$1,597.27	$1,597.27	$2,433.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $413.33 / $558.47 / $954.64	Professional		$413.33	$558.47	$954.64
United Facility/Professional Facility Modifier Low / Median / High Price $4,523.00 / $9,713.00 / $21,278.00	Facility		$4,523.00	$9,713.00	$21,278.00
United Facility/Professional Professional Modifier Low / Median / High Price $584.91 / $765.84 / $1,849.20	Professional		$584.91	$765.84	$1,849.20