Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.00 / $6,423.00 / $17,380.00	Facility		$1,169.00	$6,423.00	$17,380.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,897.10 / $2,646.48 / $8,859.60	Facility	50	$1,897.10	$2,646.48	$8,859.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.34 / $934.25 / $5,448.79	Professional		$188.34	$934.25	$5,448.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $909.86 / $5,695.62 / $5,836.85	Professional	50	$909.86	$5,695.62	$5,836.85
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 $238.37 / $4,398.79 / $9,940.62	Professional		$238.37	$4,398.79	$9,940.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $285.43 / $2,844.39 / $3,263.42	Professional	50	$285.43	$2,844.39	$3,263.42
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 $208.08 / $794.94 / $4,150.28	Professional		$208.08	$794.94	$4,150.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,809.01 / $2,137.92 / $5,036.76	Facility		$1,809.01	$2,137.92	$5,036.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.35 / $2,050.28 / $6,007.69	Professional		$211.35	$2,050.28	$6,007.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $177.59 / $240.38 / $2,362.62	Professional		$177.59	$240.38	$2,362.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.00 / $1,186.08 / $3,102.09	Professional		$181.00	$1,186.08	$3,102.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,250.94 / $2,916.93 / $5,897.00	Facility		$1,250.94	$2,916.93	$5,897.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,062.39 / $18,915.68 / $19,483.16	Professional		$11,062.39	$18,915.68	$19,483.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $210.29 / $1,675.35 / $3,437.15	Facility		$210.29	$1,675.35	$3,437.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $220.94 / $2,050.28 / $5,740.68	Professional		$220.94	$2,050.28	$5,740.68
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $507.42 / $593.96 / $342,108.00	Professional	AS	$507.42	$593.96	$342,108.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $579.66 / $579.66 / $6,484.64	Professional		$579.66	$579.66	$6,484.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $177.59 / $230.86 / $2,388.73	Professional		$177.59	$230.86	$2,388.73
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 $1,566.86 / $3,089.77 / $7,476.21	Professional		$1,566.86	$3,089.77	$7,476.21