Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.85 / $4,749.00 / $16,573.00	Facility		$242.85	$4,749.00	$16,573.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $142.90 / $162.19 / $1,134.61	Facility	54	$142.90	$162.19	$1,134.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.78 / $237.88 / $868.44	Professional		$177.78	$237.88	$868.44
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 $199.95 / $274.06 / $555.40	Professional		$199.95	$274.06	$555.40
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $166.98 / $235.42 / $515.60	Professional		$166.98	$235.42	$515.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $253.20 / $453.49	Facility		$56.00	$253.20	$453.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.89 / $289.87 / $603.10	Professional		$213.89	$289.87	$603.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $268.75 / $310.05 / $418.57	Professional		$268.75	$310.05	$418.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $226.03 / $310.56 / $535.10	Professional		$226.03	$310.56	$535.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,023.04 / $1,134.73	Facility		$55.00	$1,023.04	$1,134.73
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $701.49 / $794.31 / $794.31	Facility	54	$701.49	$794.31	$794.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,583.52 / $1,835.84 / $2,115.60	Professional		$1,583.52	$1,835.84	$2,115.60
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 $224.19 / $303.54 / $416.44	Facility		$224.19	$303.54	$416.44
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $461.89	Facility	54	$253.80	$253.80	$461.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $214.76 / $305.33 / $607.25	Professional		$214.76	$305.33	$607.25
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $694.31 / $694.31 / $792.89	Professional		$694.31	$694.31	$792.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $233.09 / $298.55 / $516.67	Professional		$233.09	$298.55	$516.67
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,523.00 / $5,830.00	Facility		$526.00	$1,523.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $184.95 / $242.55 / $545.75	Professional		$184.95	$242.55	$545.75