Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $694.55 / $6,695.00 / $18,309.00	Facility		$694.55	$6,695.00	$18,309.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $90.61 / $306.56 / $2,078.36	Facility	52	$90.61	$306.56	$2,078.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.50 / $538.65 / $958.90	Professional		$171.50	$538.65	$958.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $85.75 / $278.73 / $1,318.89	Professional	52	$85.75	$278.73	$1,318.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,944.00 / $13,707.00	Facility		$2,143.00	$5,944.00	$13,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.23 / $797.66 / $1,880.34	Professional		$267.23	$797.66	$1,880.34
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,487.53	Facility		$66.00	$100.00	$5,487.53
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $518.70 / $1,157.16	Professional		$204.05	$518.70	$1,157.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $532.04 / $532.04 / $628.77	Facility		$532.04	$532.04	$628.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.16 / $555.33 / $1,301.47	Professional		$192.16	$555.33	$1,301.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $192.52 / $727.85 / $949.00	Professional		$192.52	$727.85	$949.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $176.18 / $514.03 / $968.84	Professional		$176.18	$514.03	$968.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $859.61 / $1,050.86	Facility		$55.00	$859.61	$1,050.86
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $363.60 / $687.69 / $687.69	Facility	52	$363.60	$687.69	$687.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,434.00 / $4,779.22 / $5,225.72	Professional		$3,434.00	$4,779.22	$5,225.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $206.00 / $532.04 / $1,204.50	Facility		$206.00	$532.04	$1,204.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $192.69 / $514.53 / $1,374.80	Professional		$192.69	$514.53	$1,374.80
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $594.97 / $594.97 / $2,112.08	Professional		$594.97	$594.97	$2,112.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $177.16 / $811.57 / $1,376.81	Professional		$177.16	$811.57	$1,376.81
United Facility/Professional Facility Modifier Low / Median / High Price $5,116.00 / $9,908.00 / $23,219.00	Facility		$5,116.00	$9,908.00	$23,219.00
United Facility/Professional Professional Modifier Low / Median / High Price $516.51 / $733.49 / $1,906.53	Professional		$516.51	$733.49	$1,906.53