Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $463.75 / $5,576.00 / $17,030.00	Facility		$463.75	$5,576.00	$17,030.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.75 / $390.65 / $1,534.15	Professional		$286.75	$390.65	$1,534.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $296.95 / $296.95 / $296.95	Professional		$296.95	$296.95	$296.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,863.00 / $11,400.00	Facility		$2,143.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.65 / $530.64 / $1,097.33	Professional		$371.65	$530.64	$1,097.33
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $7,230.50	Facility		$66.00	$100.00	$7,230.50
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $264.54 / $395.92 / $934.03	Professional		$264.54	$395.92	$934.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,761.60 / $2,081.89 / $4,904.76	Facility		$1,761.60	$2,081.89	$4,904.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.85 / $471.40 / $1,092.45	Professional		$325.85	$471.40	$1,092.45
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $253.16 / $404.64 / $651.25	Professional		$253.16	$404.64	$651.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $313.50 / $461.93 / $795.53	Professional		$313.50	$461.93	$795.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,104.92 / $2,153.10 / $16,394.00	Facility		$2,104.92	$2,153.10	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,428.00 / $2,914.72 / $3,397.13	Professional		$2,428.00	$2,914.72	$3,397.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $346.55 / $467.49 / $683.24	Facility		$346.55	$467.49	$683.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $328.28 / $495.74 / $1,054.65	Professional		$328.28	$495.74	$1,054.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,015.74 / $1,015.74 / $1,333.10	Professional		$1,015.74	$1,015.74	$1,333.10
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $297.19 / $408.64 / $556.71	Professional		$297.19	$408.64	$556.71
United Facility/Professional Facility Modifier Low / Median / High Price $3,867.00 / $7,206.00 / $16,148.00	Facility		$3,867.00	$7,206.00	$16,148.00
United Facility/Professional Professional Modifier Low / Median / High Price $320.60 / $469.45 / $1,335.42	Professional		$320.60	$469.45	$1,335.42