Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,025.60 / $16,218.10	Facility		$1,698.24	$6,025.60	$16,218.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,630.27 / $5,623.41 / $18,620.87	Facility	50	$2,630.27	$5,623.41	$18,620.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $309.03 / $1,096.48	Professional		$165.96	$309.03	$1,096.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $407.38 / $549.54 / $1,819.70	Professional	50	$407.38	$549.54	$1,819.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $257.04 / $316.23	Professional		$83.18	$257.04	$316.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $426.58 / $977.24	Professional	50	$363.08	$426.58	$977.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,466.84 / $12,882.50	Facility		$2,511.89	$4,466.84	$12,882.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $380.19 / $776.25	Professional		$229.09	$380.19	$776.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $316.23 / $512.86	Professional	50	$245.47	$316.23	$512.86
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $2,511.89 / $7,762.47	Facility		$66.07	$2,511.89	$7,762.47
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $316.23 / $630.96	Professional		$177.83	$316.23	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,174.90	Facility		$1,000.00	$1,000.00	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $602.56	Professional		$181.97	$302.00	$602.56
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $416.87	Professional		$102.33	$154.88	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $281.84 / $489.78	Professional		$141.25	$281.84	$489.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $28,840.32 / $28,840.32	Facility		$5,248.07	$28,840.32	$28,840.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $363.08	Professional		$218.78	$218.78	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $316.23 / $549.54	Facility		$173.78	$316.23	$549.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $309.03 / $630.96	Professional		$181.97	$309.03	$630.96
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $831.76	Professional		$512.86	$512.86	$831.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $288.40	Professional		$125.89	$173.78	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $4,265.80 / $9,772.37	Facility		$2,344.23	$4,265.80	$9,772.37
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $257.04 / $575.44	Professional		$147.91	$257.04	$575.44