Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $731.11 / $6,631.00 / $22,330.11	Facility		$731.11	$6,631.00	$22,330.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $469.97 / $664.81 / $2,171.41	Professional		$469.97	$664.81	$2,171.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $598.32 / $598.32 / $598.32	Professional		$598.32	$598.32	$598.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $7,362.00 / $16,106.00	Facility		$2,456.00	$7,362.00	$16,106.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.65 / $774.05 / $1,506.71	Professional		$524.65	$774.05	$1,506.71
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $9,174.96	Facility		$66.90	$100.00	$9,174.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $500.80 / $715.43 / $1,416.01	Professional		$500.80	$715.43	$1,416.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $8,704.37 / $15,589.92	Facility		$2,277.00	$8,704.37	$15,589.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.70 / $796.78 / $1,654.39	Professional		$534.70	$796.78	$1,654.39
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $295.23 / $657.60 / $1,385.80	Professional		$295.23	$657.60	$1,385.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $520.57 / $893.77 / $1,564.10	Professional		$520.57	$893.77	$1,564.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,406.00 / $2,583.67 / $26,542.00	Facility		$2,406.00	$2,583.67	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $233.88 / $258.37 / $258.37	Facility	AS	$233.88	$258.37	$258.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,081.00 / $5,969.28 / $6,929.48	Professional		$4,081.00	$5,969.28	$6,929.48
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 $613.09 / $813.04 / $1,283.15	Facility		$613.09	$813.04	$1,283.15
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $317.08 / $317.08 / $317.08	Facility	80	$317.08	$317.08	$317.08
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $86.51 / $86.51 / $269.52	Facility	AS	$86.51	$86.51	$269.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $548.63 / $873.44 / $1,734.90	Professional		$548.63	$873.44	$1,734.90
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,637.78 / $1,637.78 / $2,836.33	Professional		$1,637.78	$1,637.78	$2,836.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $413.33 / $558.47 / $1,140.86	Professional		$413.33	$558.47	$1,140.86
United Facility/Professional Facility Modifier Low / Median / High Price $4,523.00 / $9,758.00 / $20,988.00	Facility		$4,523.00	$9,758.00	$20,988.00
United Facility/Professional Professional Modifier Low / Median / High Price $607.26 / $802.94 / $1,969.54	Professional		$607.26	$802.94	$1,969.54