Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.00 / $5,823.00 / $17,902.00	Facility		$1,174.00	$5,823.00	$17,902.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.13 / $100.34 / $1,952.39	Facility	52	$84.13	$100.34	$1,952.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.25 / $262.41 / $1,021.61	Professional		$168.25	$262.41	$1,021.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.13 / $233.92 / $296.33	Professional		$154.13	$233.92	$296.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.00 / $5,793.00 / $11,233.00	Facility		$1,196.00	$5,793.00	$11,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.33 / $383.39 / $1,525.41	Professional		$222.33	$383.39	$1,525.41
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $6,539.15	Facility		$67.90	$100.00	$6,539.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $194.60 / $503.16 / $1,167.26	Professional		$194.60	$503.16	$1,167.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $455.00 / $1,091.68 / $3,039.51	Facility		$455.00	$1,091.68	$3,039.51
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $360.29 / $1,261.74	Professional		$186.21	$360.29	$1,261.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $192.73 / $260.19 / $1,003.77	Professional		$192.73	$260.19	$1,003.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.33 / $534.19 / $1,041.93	Professional		$174.33	$534.19	$1,041.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,188.72 / $1,213.14 / $16,394.00	Facility		$1,188.72	$1,213.14	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $634.61 / $682.37 / $682.37	Facility	52	$634.61	$682.37	$682.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,166.58 / $4,122.24 / $4,857.08	Professional		$2,166.58	$4,122.24	$4,857.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $485.93	Professional		$32.34	$32.34	$485.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $185.67 / $308.37 / $936.64	Facility		$185.67	$308.37	$936.64
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $191.79 / $442.78 / $1,499.11	Professional		$191.79	$442.78	$1,499.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $572.46 / $572.46 / $1,980.18	Professional		$572.46	$572.46	$1,980.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $175.31 / $314.58 / $826.57	Professional		$175.31	$314.58	$826.57
United Facility/Professional Facility Modifier Low / Median / High Price $830.00 / $3,647.00 / $8,291.00	Facility		$830.00	$3,647.00	$8,291.00
United Facility/Professional Professional Modifier Low / Median / High Price $188.36 / $557.65 / $1,478.21	Professional		$188.36	$557.65	$1,478.21