Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,256.22 / $9,674.00 / $22,788.00	Facility		$1,256.22	$9,674.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $103.51 / $622.97 / $4,372.17	Facility	52	$103.51	$622.97	$4,372.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.00 / $612.09 / $1,897.79	Professional		$207.00	$612.09	$1,897.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $99.08 / $583.99 / $2,683.92	Professional	52	$99.08	$583.99	$2,683.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.34 / $219.34 / $366.30	Professional		$219.34	$219.34	$366.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.00 / $9,030.00 / $17,774.00	Facility		$3,388.00	$9,030.00	$17,774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.02 / $1,682.77 / $3,722.34	Professional		$301.02	$1,682.77	$3,722.34
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $100.00 / $15,290.89	Facility		$65.80	$100.00	$15,290.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $211.72 / $840.39 / $2,204.08	Professional		$211.72	$840.39	$2,204.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,321.99 / $3,321.99 / $3,925.98	Facility		$3,321.99	$3,321.99	$3,925.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.98 / $977.70 / $2,604.11	Professional		$227.98	$977.70	$2,604.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $247.67 / $1,112.06 / $2,032.20	Professional		$247.67	$1,112.06	$2,032.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $230.88 / $835.87 / $2,032.20	Professional		$230.88	$835.87	$2,032.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,918.66 / $2,117.46	Facility		$55.00	$1,918.66	$2,117.46
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $472.27 / $894.60 / $894.60	Facility	52	$472.27	$894.60	$894.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,299.66 / $8,227.04 / $9,699.60	Professional		$4,299.66	$8,227.04	$9,699.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $253.97 / $1,167.98 / $2,017.77	Facility		$253.97	$1,167.98	$2,017.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $234.06 / $869.07 / $2,715.13	Professional		$234.06	$869.07	$2,715.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $774.51 / $774.51 / $4,385.77	Professional		$774.51	$774.51	$4,385.77
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $224.77 / $1,217.26 / $1,673.73	Professional		$224.77	$1,217.26	$1,673.73
United Facility/Professional Facility Modifier Low / Median / High Price $6,385.00 / $13,722.00 / $29,571.00	Facility		$6,385.00	$13,722.00	$29,571.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,072.42 / $1,549.34 / $3,404.70	Professional		$1,072.42	$1,549.34	$3,404.70