Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.00 / $7,550.00 / $21,500.00	Facility		$2,700.00	$7,550.00	$21,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $605.27 / $696.59 / $2,718.00	Professional		$605.27	$696.59	$2,718.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $605.12 / $605.12 / $1,410.05	Professional		$605.12	$605.12	$1,410.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,294.00 / $8,973.00 / $18,150.00	Facility		$3,294.00	$8,973.00	$18,150.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $881.05 / $1,094.90 / $2,248.92	Professional		$881.05	$1,094.90	$2,248.92
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $8,924.67	Facility		$66.09	$100.00	$8,924.67
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $413.90 / $636.51 / $1,422.74	Professional		$413.90	$636.51	$1,422.74
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 $579.74 / $794.01 / $2,012.99	Professional		$579.74	$794.01	$2,012.99
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $434.47 / $672.14 / $2,227.42	Professional		$434.47	$672.14	$2,227.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $604.92 / $764.36 / $1,420.82	Professional		$604.92	$764.36	$1,420.82
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,207.35 / $9,011.04 / $26,542.00	Facility		$4,207.35	$9,011.04	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $143.72 / $854.12 / $854.12	Facility	AS	$143.72	$854.12	$854.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,580.16 / $4,667.04 / $5,543.70	Professional		$4,580.16	$4,667.04	$5,543.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $643.86 / $846.00 / $1,243.19	Facility		$643.86	$846.00	$1,243.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $579.74 / $793.55 / $1,818.93	Professional		$579.74	$793.55	$1,818.93
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,104.46 / $2,104.46 / $2,104.46	Professional		$2,104.46	$2,104.46	$2,104.46
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $434.47 / $624.65 / $821.86	Professional		$434.47	$624.65	$821.86
United Facility/Professional Facility Modifier Low / Median / High Price $4,509.00 / $9,759.00 / $23,219.00	Facility		$4,509.00	$9,759.00	$23,219.00
United Facility/Professional Professional Modifier Low / Median / High Price $540.67 / $786.27 / $1,725.73	Professional		$540.67	$786.27	$1,725.73