Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $873.00 / $6,695.00 / $16,756.00	Facility		$873.00	$6,695.00	$16,756.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $483.44 / $668.09 / $2,768.72	Professional		$483.44	$668.09	$2,768.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $370.44 / $409.43 / $414.98	Professional		$370.44	$409.43	$414.98
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 $545.65 / $805.03 / $1,578.93	Professional		$545.65	$805.03	$1,578.93
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $8,426.45	Facility		$66.90	$100.00	$8,426.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $503.15 / $718.79 / $1,470.55	Professional		$503.15	$718.79	$1,470.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $3,101.23 / $5,554.45	Facility		$2,000.00	$3,101.23	$5,554.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $563.24 / $849.25 / $1,749.83	Professional		$563.24	$849.25	$1,749.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $400.59 / $668.65 / $1,477.44	Professional		$400.59	$668.65	$1,477.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $539.65 / $936.01 / $1,641.60	Professional		$539.65	$936.01	$1,641.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,437.23 / $2,628.22 / $26,542.00	Facility		$2,437.23	$2,628.22	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $237.82 / $262.82 / $262.82	Facility	AS	$237.82	$262.82	$262.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,785.00 / $6,354.40 / $7,334.10	Professional		$4,785.00	$6,354.40	$7,334.10
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 $624.86 / $924.29 / $1,368.00	Facility		$624.86	$924.29	$1,368.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $338.93 / $338.93 / $338.93	Facility	80	$338.93	$338.93	$338.93
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $88.21 / $88.21 / $288.08	Facility	AS	$88.21	$88.21	$288.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $580.82 / $896.80 / $1,896.43	Professional		$580.82	$896.80	$1,896.43
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 $1,696.77 / $1,696.77 / $3,063.62	Professional		$1,696.77	$1,696.77	$3,063.62
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $505.18 / $675.27 / $1,216.49	Professional		$505.18	$675.27	$1,216.49
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 $628.32 / $850.35 / $2,106.67	Professional		$628.32	$850.35	$2,106.67