Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,165.88 / $5,460.00 / $16,210.00	Facility		$1,165.88	$5,460.00	$16,210.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $89.75 / $107.15 / $1,189.05	Facility	52	$89.75	$107.15	$1,189.05
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $42.86 / $475.62	Facility	53	$35.90	$42.86	$475.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.38 / $270.00 / $890.00	Professional		$179.38	$270.00	$890.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.52 / $267.83 / $331.14	Professional		$150.52	$267.83	$331.14
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 $237.77 / $374.02 / $768.86	Professional		$237.77	$374.02	$768.86
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 $197.16 / $395.61 / $785.60	Professional		$197.16	$395.61	$785.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $455.00 / $766.00 / $1,881.00	Facility		$455.00	$766.00	$1,881.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.74 / $353.97 / $869.08	Professional		$193.74	$353.97	$869.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $194.16 / $268.23 / $640.09	Professional		$194.16	$268.23	$640.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.36 / $387.35 / $668.00	Professional		$174.36	$387.35	$668.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,190.22 / $1,222.50 / $16,394.00	Facility		$1,190.22	$1,222.50	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $633.38 / $684.69 / $684.69	Facility	52	$633.38	$684.69	$684.69
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $158.34 / $171.17 / $171.17	Facility	53	$158.34	$171.17	$171.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,654.00 / $2,720.72 / $3,176.25	Professional		$1,654.00	$2,720.72	$3,176.25
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 $189.99 / $313.70 / $617.16	Facility		$189.99	$313.70	$617.16
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $200.23 / $413.36 / $957.04	Professional		$200.23	$413.36	$957.04
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 $577.58 / $577.58 / $1,233.96	Professional		$577.58	$577.58	$1,233.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $176.34 / $332.02 / $526.98	Professional		$176.34	$332.02	$526.98
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 $201.14 / $360.25 / $938.12	Professional		$201.14	$360.25	$938.12