Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $779.82 / $4,976.00 / $15,277.00	Facility		$779.82	$4,976.00	$15,277.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $65.66 / $150.12 / $794.66	Facility	52	$65.66	$150.12	$794.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.95 / $202.99 / $759.46	Professional		$1.95	$202.99	$759.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.33 / $135.33 / $324.08	Professional		$135.33	$135.33	$324.08
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 $177.88 / $362.48 / $708.75	Professional		$177.88	$362.48	$708.75
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,881.37	Facility		$66.00	$100.00	$6,881.37
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $153.37 / $315.02 / $620.45	Professional		$153.37	$315.02	$620.45
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 $148.56 / $308.76 / $648.36	Professional		$148.56	$308.76	$648.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $145.12 / $256.00 / $410.03	Professional		$145.12	$256.00	$410.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.32 / $262.18 / $473.64	Professional		$132.32	$262.18	$473.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,051.33 / $1,076.46 / $16,394.00	Facility		$1,051.33	$1,076.46	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $272.43 / $514.26 / $514.26	Facility	52	$272.43	$514.26	$514.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,272.00 / $2,128.05 / $6,313.62	Professional		$1,272.00	$2,128.05	$6,313.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $154.13 / $277.80 / $459.71	Facility		$154.13	$277.80	$459.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.55 / $317.19 / $638.32	Professional		$151.55	$317.19	$638.32
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $439.26 / $439.26 / $834.76	Professional		$439.26	$439.26	$834.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $161.16 / $272.52 / $383.99	Professional		$161.16	$272.52	$383.99
United Facility/Professional Facility Modifier Low / Median / High Price $2,230.00 / $4,060.00 / $9,131.00	Facility		$2,230.00	$4,060.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.64 / $322.20 / $874.48	Professional		$207.64	$322.20	$874.48