Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.89 / $4,429.00 / $14,472.00	Facility		$426.89	$4,429.00	$14,472.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.93 / $85.66 / $748.10	Facility	52	$35.93	$85.66	$748.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $14.37 / $34.26 / $299.24	Facility	53	$14.37	$34.26	$299.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.53 / $157.77 / $704.18	Professional		$65.53	$157.77	$704.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.14 / $118.26 / $347.12	Professional		$63.14	$118.26	$347.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $873.00 / $4,314.00 / $8,260.00	Facility		$873.00	$4,314.00	$8,260.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.65 / $178.91 / $419.07	Professional		$80.65	$178.91	$419.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $4,886.39	Facility		$67.90	$100.00	$4,886.39
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $158.38 / $330.69	Professional		$78.75	$158.38	$330.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $339.00 / $730.77 / $1,721.63	Facility		$339.00	$730.77	$1,721.63
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $183.57 / $574.09	Professional		$78.75	$183.57	$574.09
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $91.08 / $479.40	Professional		$72.23	$91.08	$479.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.77 / $264.04 / $516.28	Professional		$72.77	$264.04	$516.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $411.30 / $462.35 / $12,000.00	Facility		$411.30	$462.35	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $262.79 / $287.27 / $287.27	Facility	52	$262.79	$287.27	$287.27
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $65.70 / $71.81 / $71.81	Facility	53	$65.70	$71.81	$71.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,049.33 / $2,011.44 / $2,370.00	Professional		$1,049.33	$2,011.44	$2,370.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $233.84	Professional		$32.34	$32.34	$233.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $73.98 / $168.53 / $446.84	Facility		$73.98	$168.53	$446.84
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.26 / $189.99 / $690.40	Professional		$81.26	$189.99	$690.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $234.70 / $234.70 / $928.34	Professional		$234.70	$234.70	$928.34
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $66.50 / $91.43 / $410.04	Professional		$66.50	$91.43	$410.04
United Facility/Professional Facility Modifier Low / Median / High Price $833.75 / $2,562.00 / $7,655.00	Facility		$833.75	$2,562.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.01 / $268.99 / $698.14	Professional		$163.01	$268.99	$698.14