Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $320.85 / $5,073.00 / $16,210.00	Facility		$320.85	$5,073.00	$16,210.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,634.40 / $5,660.47 / $18,827.00	Facility	50	$2,634.40	$5,660.47	$18,827.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.27 / $309.05 / $1,043.00	Professional		$166.27	$309.05	$1,043.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $404.99 / $546.32 / $1,778.52	Professional	50	$404.99	$546.32	$1,778.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $345.95 / $345.95 / $692.89	Professional	50	$345.95	$345.95	$692.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,718.00 / $9,381.00	Facility		$1,787.00	$4,718.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.06 / $362.45 / $734.85	Professional		$198.06	$362.45	$734.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $250.03 / $315.72 / $507.86	Professional	50	$250.03	$315.72	$507.86
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,881.37	Facility		$66.00	$100.00	$6,881.37
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $162.76 / $274.56 / $564.33	Professional		$162.76	$274.56	$564.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.71 / $1,182.65 / $2,786.23	Facility		$1,000.71	$1,182.65	$2,786.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.98 / $310.64 / $724.41	Professional		$178.98	$310.64	$724.41
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $199.73 / $422.81	Professional		$102.38	$199.73	$422.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.41 / $280.37 / $490.09	Professional		$163.41	$280.37	$490.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.98 / $1,120.02 / $16,394.00	Facility		$1,096.98	$1,120.02	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,338.00 / $3,411.19 / $3,411.19	Professional		$3,338.00	$3,411.19	$3,411.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $188.88 / $309.27 / $516.41	Facility		$188.88	$309.27	$516.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $183.87 / $327.25 / $685.56	Professional		$183.87	$327.25	$685.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $513.29 / $513.29 / $834.26	Professional		$513.29	$513.29	$834.26
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $129.11 / $184.29 / $361.35	Professional		$129.11	$184.29	$361.35
United Facility/Professional Facility Modifier Low / Median / High Price $2,212.00 / $4,218.00 / $10,979.00	Facility		$2,212.00	$4,218.00	$10,979.00
United Facility/Professional Professional Modifier Low / Median / High Price $208.17 / $317.25 / $880.60	Professional		$208.17	$317.25	$880.60