Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $755.00 / $4,969.00 / $12,971.00	Facility		$755.00	$4,969.00	$12,971.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,415.00 / $5,940.00 / $9,696.25	Facility	50	$1,415.00	$5,940.00	$9,696.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.99 / $199.88 / $580.00	Professional		$121.99	$199.88	$580.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.92 / $265.35 / $685.00	Professional		$47.92	$265.35	$685.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,115.00 / $4,576.00 / $9,589.00	Facility		$2,115.00	$4,576.00	$9,589.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.25 / $213.44 / $399.85	Professional		$159.25	$213.44	$399.85
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 $101.41 / $155.77 / $386.31	Professional		$101.41	$155.77	$386.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $180.28 / $543.41	Professional		$136.66	$180.28	$543.41
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $111.32 / $143.29 / $171.95	Professional		$111.32	$143.29	$171.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.94 / $171.04 / $306.12	Professional		$130.94	$171.04	$306.12
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 / $334.90 / $649.94	Facility		$55.00	$334.90	$649.94
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $26.62 / $62.22 / $64.98	Facility	AS	$26.62	$62.22	$64.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $964.32 / $987.52 / $1,171.50	Professional		$964.32	$987.52	$1,171.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $130.91 / $165.62 / $229.26	Facility		$130.91	$165.62	$229.26
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $52.42 / $52.42 / $52.42	Facility	80	$52.42	$52.42	$52.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $44.56 / $44.56 / $44.56	Facility	AS	$44.56	$44.56	$44.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.55 / $180.28 / $432.41	Professional		$137.55	$180.28	$432.41
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $438.60 / $438.60 / $438.60	Professional		$438.60	$438.60	$438.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $111.32 / $155.84 / $189.24	Professional		$111.32	$155.84	$189.24
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,551.00 / $6,920.00	Facility		$548.00	$1,551.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $163.87 / $515.97	Professional		$112.84	$163.87	$515.97