Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $961.57 / $5,050.35 / $15,795.00	Facility		$961.57	$5,050.35	$15,795.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $78.09 / $93.55 / $3,725.71	Facility	52	$78.09	$93.55	$3,725.71
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $31.24 / $37.42 / $1,490.28	Facility	53	$31.24	$37.42	$1,490.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.32 / $243.59 / $1,325.28	Professional		$147.32	$243.59	$1,325.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $164.91 / $364.69	Professional		$86.38	$164.91	$364.69
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 $206.76 / $347.60 / $1,839.26	Professional		$206.76	$347.60	$1,839.26
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 $172.15 / $668.37 / $2,104.80	Professional		$172.15	$668.37	$2,104.80
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 $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.73 / $320.00 / $2,254.77	Professional		$168.73	$320.00	$2,254.77
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $169.54 / $234.21 / $1,640.48	Professional		$169.54	$234.21	$1,640.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.83 / $685.00 / $1,875.93	Professional		$151.83	$685.00	$1,875.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,035.78 / $1,063.56 / $16,394.00	Facility		$1,035.78	$1,063.56	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $551.04 / $596.83 / $596.83	Facility	52	$551.04	$596.83	$596.83
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $137.76 / $149.21 / $149.21	Facility	53	$137.76	$149.21	$149.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,836.03 / $7,375.25 / $8,642.10	Professional		$3,836.03	$7,375.25	$8,642.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $867.23	Professional		$32.34	$32.34	$867.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.13 / $271.70 / $1,665.52	Facility		$165.13	$271.70	$1,665.52
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $174.18 / $391.92 / $2,711.18	Professional		$174.18	$391.92	$2,711.18
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $2,526.00 / $2,526.00 / $2,526.00	Facility		$2,526.00	$2,526.00	$2,526.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $500.73 / $500.73 / $3,702.06	Professional		$500.73	$500.73	$3,702.06
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $153.99 / $289.91 / $1,520.34	Professional		$153.99	$289.91	$1,520.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,433.90 / $3,928.00 / $9,131.00	Facility		$1,433.90	$3,928.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $174.49 / $1,042.26 / $2,783.07	Professional		$174.49	$1,042.26	$2,783.07