Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,704.00 / $16,125.00	Facility		$344.00	$4,704.00	$16,125.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $85.38 / $99.12 / $686.01	Facility	54	$85.38	$99.12	$686.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $132.97 / $449.34	Professional		$113.84	$132.97	$449.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $59.90 / $131.44	Professional		$59.90	$59.90	$131.44
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 $115.99 / $152.16 / $300.33	Professional		$115.99	$152.16	$300.33
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 $100.00 / $133.88 / $301.87	Professional		$100.00	$133.88	$301.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $198.82 / $356.10	Facility		$56.00	$198.82	$356.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.37 / $173.16 / $361.40	Professional		$124.37	$173.16	$361.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $162.82 / $224.57	Professional		$57.06	$162.82	$224.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.91 / $186.45 / $325.02	Professional		$134.91	$186.45	$325.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $605.96 / $681.25	Facility		$55.00	$605.96	$681.25
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $416.44 / $476.87 / $476.87	Facility	54	$416.44	$476.87	$476.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $943.20 / $1,086.00 / $1,251.98	Professional		$943.20	$1,086.00	$1,251.98
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 $121.83 / $177.92 / $244.92	Facility		$121.83	$177.92	$244.92
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $149.84 / $149.84 / $269.81	Facility	54	$149.84	$149.84	$269.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.96 / $182.83 / $363.21	Professional		$128.96	$182.83	$363.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $412.00 / $412.00 / $474.51	Professional		$412.00	$412.00	$474.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.91 / $148.04 / $208.00	Professional		$63.91	$148.04	$208.00
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 $109.89 / $144.16 / $330.26	Professional		$109.89	$144.16	$330.26