Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,024.29 / $5,382.00 / $14,413.92	Facility		$1,024.29	$5,382.00	$14,413.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.25 / $29.74 / $204.86	Facility	53	$27.25	$29.74	$204.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.25 / $444.25 / $3,019.52	Professional		$136.25	$444.25	$3,019.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.95 / $212.95 / $212.95	Professional		$212.95	$212.95	$212.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,759.00 / $4,718.00 / $9,381.00	Facility		$1,759.00	$4,718.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.32 / $1,318.51 / $2,851.43	Professional		$203.32	$1,318.51	$2,851.43
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $2,102.15	Facility		$66.09	$100.00	$2,102.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $137.83 / $547.60 / $1,684.08	Professional		$137.83	$547.60	$1,684.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $894.77 / $1,057.45 / $2,491.26	Facility		$894.77	$1,057.45	$2,491.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.33 / $604.38 / $1,894.02	Professional		$161.33	$604.38	$1,894.02
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $161.66 / $878.63 / $1,297.25	Professional		$161.66	$878.63	$1,297.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.81 / $598.70 / $1,573.71	Professional		$148.81	$598.70	$1,573.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,191.96 / $1,222.61	Facility		$55.00	$1,191.96	$1,222.61
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $77.11 / $144.50 / $144.50	Facility	53	$77.11	$144.50	$144.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.72 / $5,875.68 / $6,888.08	Professional		$1,096.72	$5,875.68	$6,888.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $171.68 / $833.14 / $1,405.09	Facility		$171.68	$833.14	$1,405.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $168.41 / $604.38 / $2,136.19	Professional		$168.41	$604.38	$2,136.19
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $149.19 / $878.63 / $1,317.94	Professional		$149.19	$878.63	$1,317.94
United Facility/Professional Facility Modifier Low / Median / High Price $2,135.23 / $4,213.00 / $9,131.00	Facility		$2,135.23	$4,213.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $791.84 / $1,136.61 / $3,456.88	Professional		$791.84	$1,136.61	$3,456.88