Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,630.78 / $12,882.50	Facility		$630.96	$3,630.78	$12,882.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $575.44 / $758.58 / $7,762.47	Facility	50	$575.44	$758.58	$7,762.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $61.66 / $186.21	Professional		$28.84	$61.66	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $70.79	Professional		$29.51	$51.29	$70.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,466.84 / $12,882.50	Facility		$2,511.89	$4,466.84	$12,882.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $85.11 / $616.60	Professional		$47.86	$85.11	$616.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $371.54 / $1,230.27	Facility		$100.00	$371.54	$1,230.27
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $134.90	Professional		$37.15	$54.95	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $158.49	Professional		$35.48	$58.88	$158.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $41.69 / $144.54	Professional		$29.51	$41.69	$144.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $77.62 / $141.25	Professional		$26.92	$77.62	$141.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $2,951.21 / $2,951.21	Facility		$56.23	$2,951.21	$2,951.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $61.66 / $147.91	Facility		$33.11	$61.66	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $63.10 / $169.82	Professional		$34.67	$63.10	$169.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $275.42	Professional		$107.15	$107.15	$275.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $120.23	Professional		$23.99	$33.11	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,584.89 / $6,456.54	Facility		$588.84	$1,584.89	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $56.23 / $144.54	Professional		$30.90	$56.23	$144.54