Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $993.23 / $5,505.00 / $18,200.00	Facility		$993.23	$5,505.00	$18,200.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $106.85 / $433.93 / $3,699.54	Facility	52	$106.85	$433.93	$3,699.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.47 / $814.17 / $3,151.20	Professional		$209.47	$814.17	$3,151.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $484.49 / $484.49 / $1,054.66	Professional		$484.49	$484.49	$1,054.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,759.00 / $4,814.00 / $10,536.00	Facility		$1,759.00	$4,814.00	$10,536.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.42 / $1,686.64 / $3,364.93	Professional		$398.42	$1,686.64	$3,364.93
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $7,695.44	Facility		$66.70	$100.00	$7,695.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $240.87 / $686.84 / $1,819.74	Professional		$240.87	$686.84	$1,819.74
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 $242.59 / $881.63 / $2,713.39	Professional		$242.59	$881.63	$2,713.39
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $236.13 / $826.88 / $2,051.11	Professional		$236.13	$826.88	$2,051.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $216.41 / $941.00 / $2,233.15	Professional		$216.41	$941.00	$2,233.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,179.96 / $2,179.96	Facility		$55.00	$2,179.96	$2,179.96
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $446.89 / $841.06 / $841.06	Facility	52	$446.89	$841.06	$841.06
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,427.10 / $8,561.36 / $10,043.10	Professional		$4,427.10	$8,561.36	$10,043.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $248.93 / $833.80 / $1,997.31	Facility		$248.93	$833.80	$1,997.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $248.05 / $881.63 / $2,770.63	Professional		$248.05	$881.63	$2,770.63
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $722.93 / $722.93 / $3,713.88	Professional		$722.93	$722.93	$3,713.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $217.02 / $1,074.94 / $1,754.62	Professional		$217.02	$1,074.94	$1,754.62
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 $813.47 / $1,312.92 / $3,817.92	Professional		$813.47	$1,312.92	$3,817.92