Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,033.25 / $5,576.00 / $16,125.00	Facility		$1,033.25	$5,576.00	$16,125.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,831.65 / $5,024.04 / $10,089.00	Facility	50	$1,831.65	$5,024.04	$10,089.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.44 / $429.45 / $1,033.26	Professional		$197.44	$429.45	$1,033.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $96.63 / $549.19 / $2,312.69	Professional	50	$96.63	$549.19	$2,312.69
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $217.33 / $217.33 / $217.33	Professional	50	$217.33	$217.33	$217.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,863.00 / $11,400.00	Facility		$2,143.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $495.33 / $617.01 / $1,090.55	Professional		$495.33	$617.01	$1,090.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $282.43 / $369.89 / $407.59	Professional	50	$282.43	$369.89	$407.59
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $6,929.19	Facility		$66.70	$100.00	$6,929.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $285.81 / $449.13 / $1,039.29	Professional		$285.81	$449.13	$1,039.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,761.60 / $2,081.89 / $4,904.76	Facility		$1,761.60	$2,081.89	$4,904.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.21 / $451.91 / $1,106.35	Professional		$224.21	$451.91	$1,106.35
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $200.50 / $286.37 / $470.69	Professional		$200.50	$286.37	$470.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.48 / $312.82 / $543.11	Professional		$180.48	$312.82	$543.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,219.74 / $1,246.32 / $16,394.00	Facility		$1,219.74	$1,246.32	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,761.00 / $3,761.00 / $3,761.00	Professional		$3,761.00	$3,761.00	$3,761.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $213.86 / $380.86 / $607.59	Facility		$213.86	$380.86	$607.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $241.75 / $453.99 / $919.82	Professional		$241.75	$453.99	$919.82
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $4,239.00 / $4,239.00 / $4,239.00	Facility		$4,239.00	$4,239.00	$4,239.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $575.91 / $575.91 / $932.95	Professional		$575.91	$575.91	$932.95
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $222.54 / $310.24 / $429.56	Professional		$222.54	$310.24	$429.56
United Facility/Professional Facility Modifier Low / Median / High Price $3,459.00 / $7,359.00 / $15,471.00	Facility		$3,459.00	$7,359.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $234.32 / $379.77 / $950.53	Professional		$234.32	$379.77	$950.53