Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $674.49 / $4,848.00 / $17,701.00	Facility		$674.49	$4,848.00	$17,701.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.40 / $504.49 / $909.61	Professional		$111.40	$504.49	$909.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $239.89 / $987.86 / $987.86	Professional	50	$239.89	$987.86	$987.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $229.78 / $483.93	Professional		$43.93	$229.78	$483.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $198.33 / $198.33 / $659.90	Professional	50	$198.33	$198.33	$659.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,542.00 / $9,589.00	Facility		$1,787.00	$4,542.00	$9,589.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.57 / $456.53 / $1,316.09	Professional		$162.57	$456.53	$1,316.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $168.18 / $769.36 / $1,220.46	Professional	50	$168.18	$769.36	$1,220.46
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $27,955.87	Facility		$77.09	$100.00	$27,955.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $381.14 / $964.27	Professional		$118.69	$381.14	$964.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.74 / $181.74 / $181.74	Facility		$181.74	$181.74	$181.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.27 / $395.42 / $1,099.05	Professional		$124.27	$395.42	$1,099.05
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $84.51 / $131.30 / $893.77	Professional		$84.51	$131.30	$893.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.92 / $420.00 / $860.67	Professional		$100.92	$420.00	$860.67
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $712.50 / $939.81	Facility		$55.00	$712.50	$939.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,908.34 / $4,525.52 / $4,661.29	Professional		$1,908.34	$4,525.52	$4,661.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $434.48	Professional		$32.34	$32.34	$434.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $119.32 / $220.82 / $959.97	Facility		$119.32	$220.82	$959.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.51 / $445.63 / $1,345.14	Professional		$127.51	$445.63	$1,345.14
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $351.44 / $351.44 / $1,775.99	Professional		$351.44	$351.44	$1,775.99
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $138.55 / $736.02	Professional		$88.20	$138.55	$736.02
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,533.00 / $6,323.00	Facility		$587.00	$1,533.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $421.12 / $685.13 / $1,836.91	Professional		$421.12	$685.13	$1,836.91