Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,765.00 / $7,663.00 / $18,309.00	Facility		$2,765.00	$7,663.00	$18,309.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $50,034.00 / $50,034.00 / $50,034.00	Facility	50	$50,034.00	$50,034.00	$50,034.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.56 / $701.20 / $2,671.00	Professional		$296.56	$701.20	$2,671.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $380.54 / $578.14 / $916.08	Professional		$380.54	$578.14	$916.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,204.00 / $8,484.00 / $17,774.00	Facility		$3,204.00	$8,484.00	$17,774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $665.71 / $989.15 / $1,833.90	Professional		$665.71	$989.15	$1,833.90
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 $424.21 / $612.70 / $1,369.87	Professional		$424.21	$612.70	$1,369.87
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 $564.04 / $745.92 / $1,519.65	Professional		$564.04	$745.92	$1,519.65
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $551.00 / $644.71 / $2,214.06	Professional		$551.00	$644.71	$2,214.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $526.90 / $720.19 / $1,305.64	Professional		$526.90	$720.19	$1,305.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,553.05 / $8,957.00 / $33,500.00	Facility		$2,553.05	$8,957.00	$33,500.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $124.68 / $849.00 / $849.00	Facility	AS	$124.68	$849.00	$849.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,283.53 / $5,283.53 / $5,283.53	Professional		$5,283.53	$5,283.53	$5,283.53
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 $598.79 / $768.15 / $1,256.93	Facility		$598.79	$768.15	$1,256.93
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $207.11 / $207.11 / $207.11	Facility	80	$207.11	$207.11	$207.11
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $61.52 / $61.52 / $176.04	Facility	AS	$61.52	$61.52	$176.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $565.61 / $761.96 / $1,467.18	Professional		$565.61	$761.96	$1,467.18
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 $1,764.55 / $1,764.55 / $1,764.55	Professional		$1,764.55	$1,764.55	$1,764.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $520.46 / $715.63 / $936.71	Professional		$520.46	$715.63	$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 $436.52 / $618.33 / $1,327.18	Professional		$436.52	$618.33	$1,327.18