Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $528.66 / $5,505.00 / $17,030.00	Facility		$528.66	$5,505.00	$17,030.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.77 / $477.08 / $2,173.48	Professional		$165.77	$477.08	$2,173.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,600.30 / $2,916.85 / $2,998.00	Professional	50	$1,600.30	$2,916.85	$2,998.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,814.00 / $10,536.00	Facility		$1,787.00	$4,814.00	$10,536.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.86 / $881.93 / $1,675.40	Professional		$310.86	$881.93	$1,675.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $285.72 / $738.30 / $1,027.44	Professional	50	$285.72	$738.30	$1,027.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $7,300.60	Facility		$66.00	$100.00	$7,300.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $187.65 / $449.96 / $985.46	Professional		$187.65	$449.96	$985.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,034.30 / $2,404.17 / $5,664.01	Facility		$2,034.30	$2,404.17	$5,664.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.66 / $522.69 / $1,411.68	Professional		$190.66	$522.69	$1,411.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $203.15 / $451.23 / $853.03	Professional		$203.15	$451.23	$853.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $182.84 / $512.04 / $967.20	Professional		$182.84	$512.04	$967.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,439.06 / $1,470.56	Facility		$55.00	$1,439.06	$1,470.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,924.99 / $3,661.36 / $4,306.50	Professional		$1,924.99	$3,661.36	$4,306.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.10 / $457.53 / $862.06	Facility		$208.10	$457.53	$862.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $198.62 / $530.70 / $1,396.24	Professional		$198.62	$530.70	$1,396.24
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $580.66 / $580.66 / $1,735.94	Professional		$580.66	$580.66	$1,735.94
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $184.48 / $530.50 / $729.43	Professional		$184.48	$530.50	$729.43
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,384.00 / $16,148.00	Facility		$3,523.00	$7,384.00	$16,148.00
United Facility/Professional Professional Modifier Low / Median / High Price $413.28 / $590.40 / $1,802.70	Professional		$413.28	$590.40	$1,802.70