Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $609.00 / $3,386.00 / $11,769.00	Facility		$609.00	$3,386.00	$11,769.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $80.97 / $170.45 / $1,223.24	Facility	52	$80.97	$170.45	$1,223.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.39 / $68.18 / $403.02	Facility	53	$32.39	$68.18	$403.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.22 / $231.67 / $812.74	Professional		$74.22	$231.67	$812.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.86 / $148.96 / $368.92	Professional		$99.86	$148.96	$368.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.00 / $5,357.00 / $10,576.00	Facility		$1,196.00	$5,357.00	$10,576.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.17 / $402.05 / $753.35	Professional		$205.17	$402.05	$753.35
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $100.00 / $6,501.89	Facility		$69.80	$100.00	$6,501.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $155.66 / $358.66 / $755.26	Professional		$155.66	$358.66	$755.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $455.00 / $751.55 / $1,881.00	Facility		$455.00	$751.55	$1,881.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.34 / $366.68 / $769.47	Professional		$161.34	$366.68	$769.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $153.46 / $245.54 / $637.21	Professional		$153.46	$245.54	$637.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.11 / $352.36 / $665.70	Professional		$138.11	$352.36	$665.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $934.14 / $960.78 / $16,394.00	Facility		$934.14	$960.78	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $496.53 / $539.10 / $539.10	Facility	52	$496.53	$539.10	$539.10
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $124.13 / $134.78 / $134.78	Facility	53	$124.13	$134.78	$134.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,406.00 / $2,649.44 / $3,098.78	Professional		$1,406.00	$2,649.44	$3,098.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $339.34	Professional		$32.34	$32.34	$339.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $160.62 / $340.89 / $602.04	Facility		$160.62	$340.89	$602.04
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.23 / $369.32 / $922.98	Professional		$166.23	$369.32	$922.98
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 $452.11 / $452.11 / $1,250.33	Professional		$452.11	$452.11	$1,250.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $139.40 / $304.43 / $524.73	Professional		$139.40	$304.43	$524.73
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 $295.39 / $393.31 / $969.40	Professional		$295.39	$393.31	$969.40