Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $4,848.00 / $17,013.00	Facility		$344.00	$4,848.00	$17,013.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $58.56 / $85.56 / $532.30	Facility	52	$58.56	$85.56	$532.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.11 / $181.76 / $598.25	Professional		$117.11	$181.76	$598.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.89 / $94.89 / $94.89	Professional		$94.89	$94.89	$94.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,505.00 / $9,119.00	Facility		$1,723.00	$4,505.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.32 / $230.52 / $487.30	Professional		$151.32	$230.52	$487.30
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,170.71	Facility		$66.00	$100.00	$5,170.71
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $130.12 / $192.76 / $411.08	Professional		$130.12	$192.76	$411.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $344.93 / $407.64 / $960.38	Facility		$344.93	$407.64	$960.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.58 / $200.10 / $466.00	Professional		$128.58	$200.10	$466.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $132.15 / $203.72 / $280.02	Professional		$132.15	$203.72	$280.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.05 / $184.62 / $332.32	Professional		$118.05	$184.62	$332.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $923.86 / $945.28 / $12,000.00	Facility		$923.86	$945.28	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $237.38 / $460.86 / $460.86	Facility	52	$237.38	$460.86	$460.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $960.00 / $1,231.73 / $1,432.95	Professional		$960.00	$1,231.73	$1,432.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $136.82 / $207.61 / $308.22	Facility		$136.82	$207.61	$308.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $130.81 / $209.90 / $453.37	Professional		$130.81	$209.90	$453.37
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $371.18 / $371.18 / $563.53	Professional		$371.18	$371.18	$563.53
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $214.09 / $305.58	Professional		$146.72	$214.09	$305.58
United Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,523.00 / $6,920.00	Facility		$545.00	$1,523.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $205.40 / $665.27	Professional		$140.94	$205.40	$665.27