Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.39 / $4,950.00 / $17,133.00	Facility		$259.39	$4,950.00	$17,133.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $49.91 / $108.02 / $652.30	Facility	52	$49.91	$108.02	$652.30
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.96 / $43.21 / $260.92	Facility	53	$19.96	$43.21	$260.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.06 / $199.35 / $461.30	Professional		$91.06	$199.35	$461.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.67 / $77.67 / $77.67	Professional		$77.67	$77.67	$77.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $873.00 / $4,314.00 / $8,260.00	Facility		$873.00	$4,314.00	$8,260.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.27 / $252.54 / $486.00	Professional		$125.27	$252.54	$486.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $4,886.39	Facility		$67.90	$100.00	$4,886.39
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $99.41 / $232.61 / $509.66	Professional		$99.41	$232.61	$509.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $339.00 / $751.55 / $1,770.60	Facility		$339.00	$751.55	$1,770.60
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.77 / $234.23 / $511.13	Professional		$101.77	$234.23	$511.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $98.44 / $168.65 / $453.25	Professional		$98.44	$168.65	$453.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $253.48 / $470.73	Professional		$87.64	$253.48	$470.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $595.14 / $611.94 / $12,000.00	Facility		$595.14	$611.94	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $342.02 / $344.97 / $344.97	Facility	52	$342.02	$344.97	$344.97
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $85.51 / $86.24 / $86.24	Facility	53	$85.51	$86.24	$86.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,213.00 / $1,863.52 / $2,193.75	Professional		$1,213.00	$1,863.52	$2,193.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $314.51	Professional		$32.34	$32.34	$314.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $101.06 / $224.99 / $429.06	Facility		$101.06	$224.99	$429.06
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.68 / $238.81 / $620.12	Professional		$106.68	$238.81	$620.12
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $284.14 / $284.14 / $809.49	Professional		$284.14	$284.14	$809.49
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.40 / $219.25 / $373.24	Professional		$89.40	$219.25	$373.24
United Facility/Professional Facility Modifier Low / Median / High Price $850.11 / $3,928.00 / $9,131.00	Facility		$850.11	$3,928.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $190.65 / $254.93 / $594.19	Professional		$190.65	$254.93	$594.19