Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $706.75 / $4,200.00 / $12,448.00	Facility		$706.75	$4,200.00	$12,448.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $13,429.47 / $13,429.47 / $13,429.47	Facility	22	$13,429.47	$13,429.47	$13,429.47
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $122.26 / $231.52 / $1,367.04	Facility	52	$122.26	$231.52	$1,367.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.90 / $92.61 / $456.92	Facility	53	$48.90	$92.61	$456.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.30 / $430.80 / $1,174.13	Professional		$224.30	$430.80	$1,174.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $109.51 / $214.90 / $1,007.52	Professional	52	$109.51	$214.90	$1,007.52
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.61 / $85.43 / $245.18	Professional	53	$40.61	$85.43	$245.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.02 / $188.63 / $326.32	Professional		$164.02	$188.63	$326.32
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $44.54 / $87.13 / $185.89	Professional	52	$44.54	$87.13	$185.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $4,417.00 / $9,244.00	Facility		$1,000.00	$4,417.00	$9,244.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $298.49 / $433.95 / $864.57	Professional		$298.49	$433.95	$864.57
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 $267.64 / $491.46 / $930.08	Professional		$267.64	$491.46	$930.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $455.00 / $900.00 / $2,226.34	Facility		$455.00	$900.00	$2,226.34
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.88 / $463.89 / $900.00	Professional		$240.88	$463.89	$900.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $220.64 / $346.82 / $722.94	Professional		$220.64	$346.82	$722.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $198.56 / $422.96 / $777.00	Professional		$198.56	$422.96	$777.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,129.75 / $1,156.15 / $16,394.00	Facility		$1,129.75	$1,156.15	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $721.81 / $779.08 / $779.08	Facility	52	$721.81	$779.08	$779.08
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $180.45 / $194.77 / $194.77	Facility	53	$180.45	$194.77	$194.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,623.05 / $3,135.42 / $3,595.05	Professional		$1,623.05	$3,135.42	$3,595.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $360.67	Professional		$32.34	$32.34	$360.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $232.21 / $441.09 / $726.92	Facility		$232.21	$441.09	$726.92
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $250.63 / $493.46 / $1,061.56	Professional		$250.63	$493.46	$1,061.56
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,838.00 / $1,838.00 / $1,838.00	Facility		$1,838.00	$1,838.00	$1,838.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $655.41 / $655.41 / $1,417.57	Professional		$655.41	$655.41	$1,417.57
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $200.43 / $429.30 / $595.16	Professional		$200.43	$429.30	$595.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,089.45 / $3,964.00 / $9,131.00	Facility		$1,089.45	$3,964.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $346.94 / $490.31 / $1,077.07	Professional		$346.94	$490.31	$1,077.07