Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.75 / $3,222.00 / $13,782.00	Facility		$562.75	$3,222.00	$13,782.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $68.70 / $147.31 / $752.95	Facility	52	$68.70	$147.31	$752.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.48 / $70.41 / $4,351.72	Facility	53	$27.48	$70.41	$4,351.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.81 / $260.10 / $701.80	Professional		$122.81	$260.10	$701.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.67 / $171.96 / $274.39	Professional		$83.67	$171.96	$274.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $5,357.00 / $10,576.00	Facility		$1,000.00	$5,357.00	$10,576.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.66 / $346.91 / $650.28	Professional		$173.66	$346.91	$650.28
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $100.00 / $4,858.55	Facility		$69.80	$100.00	$4,858.55
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $138.52 / $293.32 / $599.69	Professional		$138.52	$293.32	$599.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $339.00 / $706.46 / $1,770.60	Facility		$339.00	$706.46	$1,770.60
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.16 / $304.26 / $586.69	Professional		$140.16	$304.26	$586.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $136.65 / $224.12 / $487.49	Professional		$136.65	$224.12	$487.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.99 / $283.64 / $535.76	Professional		$122.99	$283.64	$535.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $830.82 / $850.80 / $12,000.00	Facility		$830.82	$850.80	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $442.02 / $479.90 / $479.90	Facility	52	$442.02	$479.90	$479.90
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $110.50 / $119.98 / $119.98	Facility	53	$110.50	$119.98	$119.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,213.00 / $2,049.19 / $2,396.63	Professional		$1,213.00	$2,049.19	$2,396.63
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 $139.09 / $289.00 / $477.04	Facility		$139.09	$289.00	$477.04
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $146.13 / $319.35 / $718.45	Professional		$146.13	$319.35	$718.45
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,672.00 / $1,672.00 / $1,672.00	Facility		$1,672.00	$1,672.00	$1,672.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $400.63 / $400.63 / $934.38	Professional		$400.63	$400.63	$934.38
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $124.12 / $291.36 / $401.38	Professional		$124.12	$291.36	$401.38
United Facility/Professional Facility Modifier Low / Median / High Price $850.11 / $3,964.00 / $9,131.00	Facility		$850.11	$3,964.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $225.96 / $316.00 / $689.53	Professional		$225.96	$316.00	$689.53