Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,020.00 / $5,980.00 / $16,973.00	Facility		$2,020.00	$5,980.00	$16,973.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $204.24 / $217.62 / $1,260.76	Facility	52	$204.24	$217.62	$1,260.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $376.56 / $423.70 / $1,577.88	Professional		$376.56	$423.70	$1,577.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $356.49 / $479.31 / $525.42	Professional		$356.49	$479.31	$525.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,944.00 / $13,012.00	Facility		$2,143.00	$5,944.00	$13,012.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $447.23 / $580.37 / $1,159.60	Professional		$447.23	$580.37	$1,159.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $7,269.30	Facility		$66.00	$100.00	$7,269.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $350.13 / $503.26 / $1,114.52	Professional		$350.13	$503.26	$1,114.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,992.00 / $3,101.23 / $5,554.45	Facility		$1,992.00	$3,101.23	$5,554.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $434.07 / $559.45 / $1,166.58	Professional		$434.07	$559.45	$1,166.58
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $253.16 / $485.89 / $655.95	Professional		$253.16	$485.89	$655.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $401.05 / $557.01 / $980.34	Professional		$401.05	$557.01	$980.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,567.08 / $8,957.00 / $16,394.00	Facility		$1,567.08	$8,957.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $774.70 / $6,791.96 / $6,791.96	Facility	52	$774.70	$6,791.96	$6,791.96
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $96.84 / $849.00 / $849.00	Facility	AS	$96.84	$849.00	$849.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,259.28 / $3,366.84 / $3,564.15	Professional		$3,259.28	$3,366.84	$3,564.15
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 $445.61 / $564.00 / $778.64	Facility		$445.61	$564.00	$778.64
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $379.98 / $379.98 / $379.98	Facility	52	$379.98	$379.98	$379.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $47.50 / $47.50 / $136.94	Facility	AS	$47.50	$47.50	$136.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $437.40 / $587.35 / $1,128.99	Professional		$437.40	$587.35	$1,128.99
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,393.76 / $1,393.76 / $1,393.76	Professional		$1,393.76	$1,393.76	$1,393.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $329.11 / $441.36 / $539.44	Professional		$329.11	$441.36	$539.44
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,352.00 / $14,743.00	Facility		$3,523.00	$7,352.00	$14,743.00
United Facility/Professional Professional Modifier Low / Median / High Price $337.77 / $455.19 / $946.73	Professional		$337.77	$455.19	$946.73