Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $297.50 / $3,225.00 / $15,522.00	Facility		$297.50	$3,225.00	$15,522.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.57 / $95.12 / $635.17	Facility	52	$35.57	$95.12	$635.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $205.43 / $782.45	Professional		$70.98	$205.43	$782.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.57 / $95.12 / $520.59	Professional	52	$35.57	$95.12	$520.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.91 / $190.57 / $543.27	Professional		$103.91	$190.57	$543.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,505.00 / $9,119.00	Facility		$1,723.00	$4,505.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.61 / $197.84 / $473.81	Professional		$85.61	$197.84	$473.81
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,588.01	Facility		$66.00	$100.00	$1,588.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $175.48 / $409.49	Professional		$68.16	$175.48	$409.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.94 / $155.93 / $367.35	Facility		$131.94	$155.93	$367.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.64 / $194.83 / $566.95	Professional		$72.64	$194.83	$566.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $49.14 / $78.95 / $268.79	Professional		$49.14	$78.95	$268.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.73 / $191.63 / $359.96	Professional		$64.73	$191.63	$359.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $438.42 / $451.14	Facility		$55.00	$438.42	$451.14
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $130.91 / $252.78 / $252.78	Facility	52	$130.91	$252.78	$252.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $927.00 / $1,361.68 / $1,601.63	Professional		$927.00	$1,361.68	$1,601.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.20 / $153.31 / $321.02	Facility		$75.20	$153.31	$321.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.06 / $192.82 / $508.55	Professional		$74.06	$192.82	$508.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $206.05 / $206.05 / $646.03	Professional		$206.05	$206.05	$646.03
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.93 / $79.65 / $271.63	Professional		$57.93	$79.65	$271.63
United Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,533.00 / $6,920.00	Facility		$545.00	$1,533.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $147.96 / $225.99 / $653.24	Professional		$147.96	$225.99	$653.24