Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $704.84 / $4,056.00 / $14,472.00	Facility		$704.84	$4,056.00	$14,472.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $967.97 / $2,439.25 / $9,151.77	Facility	50	$967.97	$2,439.25	$9,151.77
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $48.33 / $307.39 / $1,015.10	Facility	52	$48.33	$307.39	$1,015.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.32 / $122.96 / $406.04	Facility	53	$19.32	$122.96	$406.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $315.49 / $1,359.73	Professional		$96.65	$315.49	$1,359.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.61 / $228.73 / $239.45	Professional		$123.61	$228.73	$239.45
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 $131.04 / $481.39 / $1,470.83	Professional		$131.04	$481.39	$1,470.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,117.38	Facility		$66.00	$100.00	$5,117.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $111.05 / $427.73 / $1,053.22	Professional		$111.05	$427.73	$1,053.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $419.81 / $496.13 / $1,168.84	Facility		$419.81	$496.13	$1,168.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.47 / $311.41 / $984.62	Professional		$118.47	$311.41	$984.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $92.33 / $138.50 / $469.08	Professional		$92.33	$138.50	$469.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.02 / $302.87 / $578.60	Professional		$107.02	$302.87	$578.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $611.65 / $627.00	Facility		$55.00	$611.65	$627.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $221.70 / $415.68 / $415.68	Facility	52	$221.70	$415.68	$415.68
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $55.42 / $103.92 / $103.92	Facility	53	$55.42	$103.92	$103.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,853.05 / $2,804.09 / $2,888.22	Professional		$1,853.05	$2,804.09	$2,888.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $121.78 / $306.32 / $614.79	Facility		$121.78	$306.32	$614.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.28 / $313.95 / $912.55	Professional		$123.28	$313.95	$912.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $365.14 / $365.14 / $1,041.96	Professional		$365.14	$365.14	$1,041.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $94.01 / $138.50 / $434.59	Professional		$94.01	$138.50	$434.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,731.00 / $7,940.00	Facility		$1,371.00	$2,731.00	$7,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $247.80 / $522.41 / $1,164.29	Professional		$247.80	$522.41	$1,164.29