Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $601.53 / $5,010.85 / $16,008.00	Facility		$601.53	$5,010.85	$16,008.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $65.18 / $149.47 / $760.47	Facility	52	$65.18	$149.47	$760.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.96 / $277.06 / $723.19	Professional		$121.96	$277.06	$723.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.13 / $208.45 / $332.15	Professional		$146.13	$208.45	$332.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,863.00 / $11,400.00	Facility		$2,143.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.93 / $357.84 / $683.34	Professional		$174.93	$357.84	$683.34
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 $149.68 / $308.83 / $619.65	Professional		$149.68	$308.83	$619.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.71 / $1,182.65 / $2,786.23	Facility		$1,000.71	$1,182.65	$2,786.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.96 / $301.61 / $634.49	Professional		$146.96	$301.61	$634.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $142.78 / $197.92 / $401.62	Professional		$142.78	$197.92	$401.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.91 / $257.52 / $463.41	Professional		$129.91	$257.52	$463.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,037.05 / $1,065.96 / $12,000.00	Facility		$1,037.05	$1,065.96	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $267.04 / $507.15 / $507.15	Facility	52	$267.04	$507.15	$507.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,212.00 / $1,812.48 / $2,099.69	Professional		$1,212.00	$1,812.48	$2,099.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.69 / $272.58 / $455.43	Facility		$151.69	$272.58	$455.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $149.53 / $310.29 / $622.32	Professional		$149.53	$310.29	$622.32
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $427.92 / $427.92 / $800.59	Professional		$427.92	$427.92	$800.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $158.50 / $230.90 / $343.33	Professional		$158.50	$230.90	$343.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,212.00 / $4,218.00 / $10,979.00	Facility		$2,212.00	$4,218.00	$10,979.00
United Facility/Professional Professional Modifier Low / Median / High Price $199.81 / $313.87 / $841.52	Professional		$199.81	$313.87	$841.52