Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $872.13 / $6,342.00 / $18,293.00	Facility		$872.13	$6,342.00	$18,293.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $114.87 / $355.68 / $1,935.45	Facility	52	$114.87	$355.68	$1,935.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.46 / $662.39 / $1,316.01	Professional		$224.46	$662.39	$1,316.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $320.14 / $371.84 / $392.00	Professional		$320.14	$371.84	$392.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,208.00 / $5,803.00 / $11,233.00	Facility		$1,208.00	$5,803.00	$11,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.76 / $999.75 / $2,136.39	Professional		$316.76	$999.75	$2,136.39
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 $258.14 / $637.87 / $1,432.70	Professional		$258.14	$637.87	$1,432.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $1,449.30 / $3,870.53	Facility		$633.00	$1,449.30	$3,870.53
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.88 / $679.00 / $1,480.48	Professional		$252.88	$679.00	$1,480.48
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $210.72 / $295.86 / $1,230.70	Professional		$210.72	$295.86	$1,230.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.61 / $660.51 / $1,276.85	Professional		$221.61	$660.51	$1,276.85
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,514.10 / $1,514.10 / $3,598.00	Facility		$1,514.10	$1,514.10	$3,598.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $805.34 / $870.09 / $870.09	Facility	52	$805.34	$870.09	$870.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,647.15 / $5,068.16 / $5,941.05	Professional		$2,647.15	$5,068.16	$5,941.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $597.05	Professional		$32.34	$32.34	$597.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $235.83 / $636.46 / $1,197.81	Facility		$235.83	$636.46	$1,197.81
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $266.43 / $702.72 / $1,796.50	Professional		$266.43	$702.72	$1,796.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $734.43 / $734.43 / $2,401.82	Professional		$734.43	$734.43	$2,401.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $210.72 / $273.94 / $1,013.53	Professional		$210.72	$273.94	$1,013.53
United Facility/Professional Facility Modifier Low / Median / High Price $1,433.90 / $3,964.00 / $9,131.00	Facility		$1,433.90	$3,964.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $569.79 / $813.99 / $1,831.58	Professional		$569.79	$813.99	$1,831.58