Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,353.00 / $6,588.00 / $17,538.00	Facility		$1,353.00	$6,588.00	$17,538.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,666.93 / $2,753.84 / $18,766.93	Facility	50	$1,666.93	$2,753.84	$18,766.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $1,797.51 / $2,941.01	Professional		$158.83	$1,797.51	$2,941.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.09 / $1,529.79 / $2,885.34	Professional	50	$126.09	$1,529.79	$2,885.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $6,191.00 / $13,697.00	Facility		$2,456.00	$6,191.00	$13,697.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.84 / $2,368.03 / $5,746.75	Professional		$199.84	$2,368.03	$5,746.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $251.17 / $2,806.11 / $3,214.06	Professional	50	$251.17	$2,806.11	$3,214.06
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,510.42	Facility		$66.00	$100.00	$5,510.42
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $175.04 / $685.19 / $4,064.82	Professional		$175.04	$685.19	$4,064.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,884.22 / $4,590.43 / $10,814.67	Facility		$3,884.22	$4,590.43	$10,814.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.42 / $2,023.86 / $5,540.37	Professional		$181.42	$2,023.86	$5,540.37
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $149.29 / $211.64 / $2,753.89	Professional		$149.29	$211.64	$2,753.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.07 / $1,486.23 / $2,998.62	Professional		$159.07	$1,486.23	$2,998.62
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,076.76 / $1,101.00 / $5,897.00	Facility		$1,076.76	$1,101.00	$5,897.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,092.23 / $11,235.92 / $13,289.25	Professional		$6,092.23	$11,235.92	$13,289.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $184.75 / $1,617.77 / $2,971.57	Facility		$184.75	$1,617.77	$2,971.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $185.76 / $2,023.86 / $4,926.82	Professional		$185.76	$2,023.86	$4,926.82
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $588.94 / $745.40 / $403,200.00	Professional	80	$588.94	$745.40	$403,200.00
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $500.60 / $633.59 / $342,720.00	Professional	AS	$500.60	$633.59	$342,720.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $509.27 / $509.27 / $6,402.22	Professional		$509.27	$509.27	$6,402.22
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $149.29 / $195.76 / $2,356.06	Professional		$149.29	$195.76	$2,356.06
United Facility/Professional Facility Modifier Low / Median / High Price $4,509.00 / $9,758.00 / $22,073.00	Facility		$4,509.00	$9,758.00	$22,073.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,552.67 / $2,355.77 / $6,236.45	Professional		$1,552.67	$2,355.77	$6,236.45