Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $534.75 / $3,672.00 / $13,290.00	Facility		$534.75	$3,672.00	$13,290.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $575.10 / $757.12 / $2,030.82	Facility	50	$575.10	$757.12	$2,030.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.41 / $43.64 / $170.04	Professional		$30.41	$43.64	$170.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $59.41 / $70.81	Professional		$31.00	$59.41	$70.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,988.00 / $4,544.00 / $9,274.00	Facility		$1,988.00	$4,544.00	$9,274.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.09 / $67.92 / $566.10	Professional		$42.09	$67.92	$566.10
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $275.42 / $1,203.19	Facility		$95.50	$275.42	$1,203.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $41.94 / $111.85	Professional		$33.34	$41.94	$111.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.50 / $54.50 / $54.50	Facility		$54.50	$54.50	$54.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $57.67 / $161.88	Professional		$34.78	$57.67	$161.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $48.22 / $140.06	Professional		$34.44	$48.22	$140.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $75.95 / $138.72	Professional		$31.28	$75.95	$138.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $143.82 / $153.66	Facility		$55.00	$143.82	$153.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,650.00 / $1,650.00 / $1,650.00	Professional		$1,650.00	$1,650.00	$1,650.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $68.48	Professional		$32.34	$32.34	$68.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.06 / $58.70 / $142.47	Facility		$34.06	$58.70	$142.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $74.23 / $206.86	Professional		$36.70	$74.23	$206.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $108.34 / $108.34 / $276.64	Professional		$108.34	$108.34	$276.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $27.80 / $38.22 / $115.32	Professional		$27.80	$38.22	$115.32
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 $35.90 / $84.69 / $238.39	Professional		$35.90	$84.69	$238.39