Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.00 / $3,747.00 / $15,795.00	Facility		$194.00	$3,747.00	$15,795.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $98.96 / $110.60 / $779.42	Facility	54	$98.96	$110.60	$779.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.49 / $154.19 / $487.40	Professional		$129.49	$154.19	$487.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $294.58 / $294.58 / $294.58	Professional		$294.58	$294.58	$294.58
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 $136.94 / $179.48 / $345.10	Professional		$136.94	$179.48	$345.10
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 $108.86 / $155.51 / $354.86	Professional		$108.86	$155.51	$354.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $215.98 / $386.84	Facility		$56.00	$215.98	$386.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.18 / $195.26 / $409.32	Professional		$146.18	$195.26	$409.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $183.89 / $248.25	Professional		$61.80	$183.89	$248.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.36 / $211.58 / $368.82	Professional		$153.36	$211.58	$368.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $697.92 / $773.06	Facility		$55.00	$697.92	$773.06
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $474.73 / $541.14 / $541.14	Facility	54	$474.73	$541.14	$541.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,082.24 / $1,248.08 / $1,429.13	Professional		$1,082.24	$1,248.08	$1,429.13
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 $150.96 / $209.12 / $287.89	Facility		$150.96	$209.12	$287.89
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $171.92 / $171.92 / $311.57	Facility	54	$171.92	$171.92	$311.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $146.56 / $206.58 / $413.03	Professional		$146.56	$206.58	$413.03
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $472.65 / $472.65 / $543.58	Professional		$472.65	$472.65	$543.58
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $69.22 / $148.63 / $237.05	Professional		$69.22	$148.63	$237.05
United Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $1,506.00 / $5,830.00	Facility		$510.00	$1,506.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.74 / $162.91 / $366.47	Professional		$125.74	$162.91	$366.47