Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $927.00 / $7,444.00 / $18,668.59	Facility		$927.00	$7,444.00	$18,668.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $552.90 / $777.38 / $2,942.15	Professional		$552.90	$777.38	$2,942.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $498.98 / $553.79 / $982.32	Professional		$498.98	$553.79	$982.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,776.00 / $9,030.00 / $17,774.00	Facility		$2,776.00	$9,030.00	$17,774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $604.47 / $813.48 / $1,669.61	Professional		$604.47	$813.48	$1,669.61
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $10,987.72	Facility		$66.90	$100.00	$10,987.72
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $578.62 / $826.60 / $1,670.17	Professional		$578.62	$826.60	$1,670.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,813.00 / $9,727.56 / $17,422.49	Facility		$2,813.00	$9,727.56	$17,422.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $622.08 / $898.42 / $1,659.85	Professional		$622.08	$898.42	$1,659.85
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $299.33 / $743.48 / $1,273.70	Professional		$299.33	$743.48	$1,273.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $589.46 / $861.45 / $1,470.86	Professional		$589.46	$861.45	$1,470.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,722.60 / $2,922.77 / $26,542.00	Facility		$2,722.60	$2,922.77	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $264.92 / $292.27 / $292.27	Facility	AS	$264.92	$292.27	$292.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,220.47 / $5,611.44 / $6,523.73	Professional		$4,220.47	$5,611.44	$6,523.73
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 $611.35 / $864.24 / $1,273.70	Facility		$611.35	$864.24	$1,273.70
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $298.83 / $298.83 / $298.83	Facility	80	$298.83	$298.83	$298.83
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $97.86 / $97.86 / $254.02	Facility	AS	$97.86	$97.86	$254.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $635.23 / $969.25 / $1,801.74	Professional		$635.23	$969.25	$1,801.74
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $11,105.00 / $11,105.00 / $11,105.00	Facility		$11,105.00	$11,105.00	$11,105.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,913.94 / $1,913.94 / $2,656.87	Professional		$1,913.94	$1,913.94	$2,656.87
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $419.06 / $614.11 / $1,048.25	Professional		$419.06	$614.11	$1,048.25
United Facility/Professional Facility Modifier Low / Median / High Price $7,212.00 / $13,651.00 / $28,973.00	Facility		$7,212.00	$13,651.00	$28,973.00
United Facility/Professional Professional Modifier Low / Median / High Price $633.02 / $832.80 / $1,822.11	Professional		$633.02	$832.80	$1,822.11