Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,848.00 / $16,573.00	Facility		$344.00	$4,848.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $157.13 / $172.82 / $1,172.86	Facility	54	$157.13	$172.82	$1,172.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.16 / $241.74 / $679.22	Professional		$195.16	$241.74	$679.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.13 / $229.13 / $229.13	Professional		$229.13	$229.13	$229.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,464.00 / $8,976.00	Facility		$1,723.00	$4,464.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.87 / $292.99 / $600.71	Professional		$219.87	$292.99	$600.71
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,367.09	Facility		$66.00	$100.00	$5,367.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $186.94 / $256.24 / $571.34	Professional		$186.94	$256.24	$571.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.20 / $253.65 / $1,487.00	Facility		$253.20	$253.65	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.49 / $302.73 / $629.03	Professional		$228.49	$302.73	$629.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $161.90 / $294.86 / $398.06	Professional		$161.90	$294.86	$398.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $244.21 / $327.80 / $585.44	Professional		$244.21	$327.80	$585.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,117.64 / $1,240.89 / $12,000.00	Facility		$1,117.64	$1,240.89	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $764.03 / $868.62 / $868.62	Facility	54	$764.03	$868.62	$868.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,726.16 / $1,896.64 / $2,181.30	Professional		$1,726.16	$1,896.64	$2,181.30
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 $234.23 / $317.30 / $434.20	Facility		$234.23	$317.30	$434.20
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $275.81 / $275.81 / $474.74	Facility	54	$275.81	$275.81	$474.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $231.81 / $323.33 / $641.03	Professional		$231.81	$323.33	$641.03
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $755.26 / $755.26 / $820.18	Professional		$755.26	$755.26	$820.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $181.33 / $268.04 / $355.69	Professional		$181.33	$268.04	$355.69
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,506.00 / $5,830.00	Facility		$526.00	$1,506.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.23 / $255.25 / $560.41	Professional		$192.23	$255.25	$560.41