Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.50 / $4,436.00 / $17,902.00	Facility		$259.50	$4,436.00	$17,902.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.77 / $117.51 / $684.80	Facility	52	$56.77	$117.51	$684.80
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.71 / $47.00 / $273.92	Facility	53	$22.71	$47.00	$273.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.95 / $206.72 / $526.92	Professional		$92.95	$206.72	$526.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.58 / $75.58 / $78.02	Professional		$75.58	$75.58	$78.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,785.00 / $9,596.00	Facility		$1,787.00	$4,785.00	$9,596.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.68 / $331.33 / $666.91	Professional		$166.68	$331.33	$666.91
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,170.71	Facility		$66.00	$100.00	$5,170.71
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $127.73 / $240.89 / $453.93	Professional		$127.73	$240.89	$453.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,006.98 / $2,006.98 / $2,371.89	Facility		$2,006.98	$2,006.98	$2,371.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.19 / $235.67 / $511.00	Professional		$110.19	$235.67	$511.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $74.09 / $106.34 / $350.77	Professional		$74.09	$106.34	$350.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $203.83 / $351.01	Professional		$82.13	$203.83	$351.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $471.85 / $485.15 / $12,000.00	Facility		$471.85	$485.15	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $169.34 / $319.13 / $319.13	Facility	52	$169.34	$319.13	$319.13
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $42.33 / $79.78 / $79.78	Facility	53	$42.33	$79.78	$79.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,374.00 / $1,989.58 / $1,989.58	Professional		$1,374.00	$1,989.58	$1,989.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.56 / $214.00 / $455.53	Facility		$98.56	$214.00	$455.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $238.03 / $531.48	Professional		$111.95	$238.03	$531.48
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $274.72 / $274.72 / $709.90	Professional		$274.72	$274.72	$709.90
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $74.09 / $103.72 / $288.77	Professional		$74.09	$103.72	$288.77
United Facility/Professional Facility Modifier Low / Median / High Price $1,407.00 / $2,838.06 / $11,305.00	Facility		$1,407.00	$2,838.06	$11,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.82 / $273.19 / $637.60	Professional		$179.82	$273.19	$637.60