Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,032.50 / $4,848.00 / $16,573.00	Facility		$1,032.50	$4,848.00	$16,573.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $996.88 / $2,432.19	Professional		$87.73	$996.88	$2,432.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.83 / $838.95 / $961.99	Professional		$100.83	$838.95	$961.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,539.00 / $9,589.00	Facility		$1,787.00	$4,539.00	$9,589.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.52 / $2,064.94 / $4,353.97	Professional		$148.52	$2,064.94	$4,353.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $141.37 / $1,641.76 / $2,829.12	Professional	50	$141.37	$1,641.76	$2,829.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $27,955.87	Facility		$77.09	$100.00	$27,955.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $95.06 / $358.49 / $2,820.81	Professional		$95.06	$358.49	$2,820.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.18 / $150.18 / $150.18	Facility		$150.18	$150.18	$150.18
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $93.86 / $93.86 / $93.86	Facility	62	$93.86	$93.86	$93.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $703.92 / $2,618.17	Professional		$96.70	$703.92	$2,618.17
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.18 / $1,301.19 / $1,606.93	Professional		$89.18	$1,301.19	$1,606.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.25 / $743.70 / $1,586.95	Professional		$84.25	$743.70	$1,586.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,494.91 / $1,627.60	Facility		$55.00	$1,494.91	$1,627.60
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $246.93 / $255.55 / $255.55	Facility	62	$246.93	$255.55	$255.55
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,337.04 / $6,712.53 / $7,523.03	Professional		$3,337.04	$6,712.53	$7,523.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $776.87	Professional		$32.34	$32.34	$776.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.35 / $740.71 / $1,670.82	Facility		$94.35	$740.71	$1,670.82
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $93.86 / $1,488.06 / $1,488.06	Facility	62	$93.86	$1,488.06	$1,488.06
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $380.94 / $380.94 / $380.94	Facility	80	$380.94	$380.94	$380.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.13 / $877.03 / $2,664.05	Professional		$101.13	$877.03	$2,664.05
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $341.57 / $420.79 / $552.94	Professional	80	$341.57	$420.79	$552.94
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $290.33 / $357.67 / $470.00	Professional	AS	$290.33	$357.67	$470.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $286.58 / $286.58 / $3,972.38	Professional		$286.58	$286.58	$3,972.38
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $962.70 / $1,691.55	Professional		$71.86	$962.70	$1,691.55
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $6,323.00	Facility		$587.00	$1,551.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $965.41 / $1,498.05 / $3,458.78	Professional		$965.41	$1,498.05	$3,458.78