Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $3,467.37 / $12,302.69	Facility		$575.44	$3,467.37	$12,302.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $1,778.28 / $3,801.89 / $4,365.16	Facility	53	$1,778.28	$3,801.89	$4,365.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $251.19 / $724.44	Professional		$114.82	$251.19	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $234.42	Professional		$93.33	$114.82	$234.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $6,165.95 / $13,489.63	Facility		$3,630.78	$6,165.95	$13,489.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $338.84 / $616.60	Professional		$190.55	$338.84	$616.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $1,621.81 / $5,623.41	Facility		$66.07	$1,621.81	$5,623.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $338.84 / $660.69	Professional		$147.91	$338.84	$660.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $645.65 / $1,288.25	Facility		$398.11	$645.65	$1,288.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $295.12 / $537.03	Professional		$141.25	$295.12	$537.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $223.87 / $549.54	Professional		$125.89	$223.87	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $309.03 / $602.56	Professional		$114.82	$309.03	$602.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $19,498.45	Facility		$2,884.03	$2,884.03	$19,498.45
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	52	$2,290.87	$2,290.87	$2,290.87
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	53	$575.44	$575.44	$575.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,398.83 / $2,398.83	Professional		$2,041.74	$2,398.83	$2,398.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $398.11	Professional		$239.88	$239.88	$398.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $295.12 / $549.54	Facility		$134.90	$295.12	$549.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $302.00 / $602.56	Professional		$141.25	$302.00	$602.56
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Facility		$1,659.59	$1,659.59	$1,659.59
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $933.25	Professional		$398.11	$398.11	$933.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $346.74 / $478.63	Professional		$114.82	$346.74	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,981.07 / $9,120.11	Facility		$1,778.28	$3,981.07	$9,120.11
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $239.88 / $457.09	Professional		$112.20	$239.88	$457.09