Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,289.39 / $3,289.39 / $77,934.60	Facility		$3,289.39	$3,289.39	$77,934.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,281.42 / $3,289.39 / $77,934.60	Professional		$2,281.42	$3,289.39	$77,934.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,719.37 / $3,719.37 / $3,719.37	Professional		$3,719.37	$3,719.37	$3,719.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,445.00 / $9,260.00 / $17,774.00	Facility		$3,445.00	$9,260.00	$17,774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $863.20 / $15,061.01 / $35,685.28	Professional		$863.20	$15,061.01	$35,685.28
Anthem BCBS Facility/Professional Professional Modifier 80 Low / Median / High Price $123.51 / $1,785.87 / $1,899.37	Professional	80	$123.51	$1,785.87	$1,899.37
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $108.07 / $1,562.64 / $1,661.95	Professional	AS	$108.07	$1,562.64	$1,661.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $4,062.37 / $7,900.99 / $17,708.50	Facility		$4,062.37	$7,900.99	$17,708.50
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $680.95 / $6,592.71 / $27,363.84	Professional		$680.95	$6,592.71	$27,363.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $890.95 / $1,284.94 / $20,280.56	Professional		$890.95	$1,284.94	$20,280.56
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $523.83 / $713.11 / $14,860.15	Professional		$523.83	$713.11	$14,860.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $568.66 / $6,043.98 / $14,860.15	Professional		$568.66	$6,043.98	$14,860.15
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 $55.00 / $13,750.19 / $13,750.19	Facility		$55.00	$13,750.19	$13,750.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $31,793.20 / $59,714.29 / $69,100.80	Professional		$31,793.20	$59,714.29	$69,100.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $650.45 / $1,421.62 / $15,804.22	Facility		$650.45	$1,421.62	$15,804.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $568.66 / $1,707.87 / $24,801.30	Professional		$568.66	$1,707.87	$24,801.30
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $3,968.21 / $4,999.68 / $403,200.00	Professional	80	$3,968.21	$4,999.68	$403,200.00
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $3,372.98 / $4,249.72 / $342,720.00	Professional	AS	$3,372.98	$4,249.72	$342,720.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,910.77 / $1,910.77 / $38,381.65	Professional		$1,910.77	$1,910.77	$38,381.65
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $523.83 / $680.97 / $12,242.04	Professional		$523.83	$680.97	$12,242.04
United Facility/Professional Facility Modifier Low / Median / High Price $14,011.44 / $14,011.44 / $14,011.44	Facility		$14,011.44	$14,011.44	$14,011.44
United Facility/Professional Professional Modifier Low / Median / High Price $9,107.46 / $13,509.74 / $41,264.44	Professional		$9,107.46	$13,509.74	$41,264.44