Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $546.00 / $3,989.00 / $15,234.00	Facility		$546.00	$3,989.00	$15,234.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.82 / $204.13 / $1,340.69	Facility	52	$40.82	$204.13	$1,340.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.32 / $81.65 / $536.28	Facility	53	$16.32	$81.65	$536.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.50 / $379.92 / $1,359.37	Professional		$78.50	$379.92	$1,359.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,944.00 / $12,615.00	Facility		$2,143.00	$5,944.00	$12,615.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.77 / $535.55 / $1,183.80	Professional		$115.77	$535.55	$1,183.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,809.99	Facility		$66.00	$100.00	$5,809.99
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $298.82 / $716.94	Professional		$88.20	$298.82	$716.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $798.91 / $798.91 / $944.16	Facility		$798.91	$798.91	$944.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.06 / $332.82 / $824.88	Professional		$87.06	$332.82	$824.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.36 / $362.99 / $648.57	Professional		$89.36	$362.99	$648.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.52 / $268.08 / $648.57	Professional		$81.52	$268.08	$648.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $468.20 / $477.85	Facility		$55.00	$468.20	$477.85
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $169.36 / $318.74 / $318.74	Facility	52	$169.36	$318.74	$318.74
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $42.34 / $79.69 / $79.69	Facility	53	$42.34	$79.69	$79.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,338.29 / $2,634.80 / $3,084.45	Professional		$1,338.29	$2,634.80	$3,084.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.67 / $379.92 / $659.91	Facility		$89.67	$379.92	$659.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $293.00 / $842.68	Professional		$88.50	$293.00	$842.68
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $275.44 / $275.44 / $1,348.96	Professional		$275.44	$275.44	$1,348.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $388.53 / $544.49	Professional		$81.16	$388.53	$544.49
United Facility/Professional Facility Modifier Low / Median / High Price $2,090.00 / $4,218.00 / $12,907.00	Facility		$2,090.00	$4,218.00	$12,907.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.64 / $487.61 / $1,221.72	Professional		$318.64	$487.61	$1,221.72