Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,949.85 / $7,584.00 / $17,810.00	Facility		$2,949.85	$7,584.00	$17,810.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.57 / $854.88 / $2,941.00	Professional		$575.57	$854.88	$2,941.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $240.85 / $540.22 / $768.05	Professional		$240.85	$540.22	$768.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,403.00 / $9,447.00 / $18,544.00	Facility		$3,403.00	$9,447.00	$18,544.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $712.69 / $1,058.96 / $1,963.31	Professional		$712.69	$1,058.96	$1,963.31
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $9,677.87	Facility		$66.90	$100.00	$9,677.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $440.64 / $635.49 / $1,420.00	Professional		$440.64	$635.49	$1,420.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,813.00 / $3,106.72 / $5,554.45	Facility		$2,813.00	$3,106.72	$5,554.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $584.51 / $789.49 / $1,576.34	Professional		$584.51	$789.49	$1,576.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $551.00 / $666.79 / $2,214.06	Professional		$551.00	$666.79	$2,214.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $545.67 / $745.68 / $1,333.88	Professional		$545.67	$745.68	$1,333.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,648.80 / $8,957.00 / $26,542.00	Facility		$2,648.80	$8,957.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $129.22 / $849.00 / $849.00	Facility	AS	$129.22	$849.00	$849.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,386.47 / $6,386.47 / $6,386.47	Professional		$6,386.47	$6,386.47	$6,386.47
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 $633.60 / $800.15 / $1,317.89	Facility		$633.60	$800.15	$1,317.89
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $63.83 / $63.83 / $182.71	Facility	AS	$63.83	$63.83	$182.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $587.34 / $815.25 / $1,522.67	Professional		$587.34	$815.25	$1,522.67
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $4,916.00 / $4,916.00 / $4,916.00	Facility		$4,916.00	$4,916.00	$4,916.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,830.33 / $1,830.33 / $1,830.33	Professional		$1,830.33	$1,830.33	$1,830.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $538.26 / $716.31 / $936.71	Professional		$538.26	$716.31	$936.71
United Facility/Professional Facility Modifier Low / Median / High Price $4,763.00 / $9,758.00 / $21,278.00	Facility		$4,763.00	$9,758.00	$21,278.00
United Facility/Professional Professional Modifier Low / Median / High Price $453.04 / $647.60 / $1,389.87	Professional		$453.04	$647.60	$1,389.87