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 $132.29 / $149.47 / $1,006.96	Facility	54	$132.29	$149.47	$1,006.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $200.16 / $537.91	Professional		$164.59	$200.16	$537.91
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 $183.86 / $254.50 / $506.61	Professional		$183.86	$254.50	$506.61
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 $157.06 / $216.87 / $485.16	Professional		$157.06	$216.87	$485.16
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 $196.31 / $262.32 / $538.95	Professional		$196.31	$262.32	$538.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $244.84 / $330.53	Professional		$144.41	$244.84	$330.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.34 / $278.81 / $486.87	Professional		$204.34	$278.81	$486.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $929.84 / $1,031.60	Facility		$55.00	$929.84	$1,031.60
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $635.79 / $722.13 / $722.13	Facility	54	$635.79	$722.13	$722.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,440.80 / $1,669.19 / $1,856.18	Professional		$1,440.80	$1,669.19	$1,856.18
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 $206.79 / $272.45 / $372.72	Facility		$206.79	$272.45	$372.72
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $405.35	Facility	54	$230.05	$230.05	$405.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $198.21 / $281.85 / $543.85	Professional		$198.21	$281.85	$543.85
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $631.84 / $631.84 / $703.96	Professional		$631.84	$631.84	$703.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $161.75 / $222.58 / $303.70	Professional		$161.75	$222.58	$303.70
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $6,323.00	Facility		$548.00	$1,533.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.20 / $218.52 / $484.49	Professional		$166.20	$218.52	$484.49