Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $642.76 / $5,483.27 / $16,973.00	Facility		$642.76	$5,483.27	$16,973.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.65 / $517.86 / $1,619.51	Professional		$328.65	$517.86	$1,619.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.62 / $247.62 / $247.62	Professional		$247.62	$247.62	$247.62
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 $381.78 / $545.10 / $1,096.32	Professional		$381.78	$545.10	$1,096.32
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $7,269.30	Facility		$66.00	$100.00	$7,269.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $377.76 / $554.66 / $1,082.83	Professional		$377.76	$554.66	$1,082.83
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 $399.23 / $593.53 / $1,134.86	Professional		$399.23	$593.53	$1,134.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $236.04 / $512.25 / $952.74	Professional		$236.04	$512.25	$952.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $401.43 / $628.66 / $1,076.83	Professional		$401.43	$628.66	$1,076.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,843.36 / $1,999.28 / $16,394.00	Facility		$1,843.36	$1,999.28	$16,394.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $179.69 / $199.93 / $199.93	Facility	AS	$179.69	$199.93	$199.93
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,869.12 / $4,116.96 / $4,780.05	Professional		$2,869.12	$4,116.96	$4,780.05
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 $432.00 / $588.00 / $890.73	Facility		$432.00	$588.00	$890.73
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $216.62 / $216.62 / $216.62	Facility	80	$216.62	$216.62	$216.62
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $66.11 / $66.11 / $184.12	Facility	AS	$66.11	$66.11	$184.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $401.43 / $639.01 / $1,281.54	Professional		$401.43	$639.01	$1,281.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,256.82 / $1,256.82 / $1,913.20	Professional		$1,256.82	$1,256.82	$1,913.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $330.45 / $446.49 / $784.31	Professional		$330.45	$446.49	$784.31
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,352.00 / $14,743.00	Facility		$3,523.00	$7,352.00	$14,743.00
United Facility/Professional Professional Modifier Low / Median / High Price $432.67 / $572.24 / $1,314.69	Professional		$432.67	$572.24	$1,314.69