Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $721.77 / $5,980.00 / $18,133.40	Facility		$721.77	$5,980.00	$18,133.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $156.04 / $303.80 / $1,897.73	Facility	52	$156.04	$303.80	$1,897.73
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.42 / $121.52 / $759.09	Facility	53	$62.42	$121.52	$759.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.37 / $563.69 / $1,304.50	Professional		$286.37	$563.69	$1,304.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.91 / $223.91 / $269.08	Professional		$223.91	$223.91	$269.08
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 $382.06 / $575.54 / $1,106.60	Professional		$382.06	$575.54	$1,106.60
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 $339.77 / $626.57 / $1,207.51	Professional		$339.77	$626.57	$1,207.51
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 $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.36 / $612.09 / $1,399.79	Professional		$303.36	$612.09	$1,399.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $283.60 / $436.36 / $986.40	Professional		$283.60	$436.36	$986.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $254.91 / $614.41 / $1,153.40	Professional		$254.91	$614.41	$1,153.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,452.35 / $1,489.15 / $16,394.00	Facility		$1,452.35	$1,489.15	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $926.46 / $1,001.00 / $1,001.00	Facility	52	$926.46	$1,001.00	$1,001.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $231.61 / $250.25 / $250.25	Facility	53	$231.61	$250.25	$250.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,437.02 / $4,654.56 / $5,434.43	Professional		$2,437.02	$4,654.56	$5,434.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $548.34	Professional		$32.34	$32.34	$548.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $298.68 / $610.99 / $1,041.97	Facility		$298.68	$610.99	$1,041.97
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $316.20 / $667.98 / $1,649.21	Professional		$316.20	$667.98	$1,649.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $847.50 / $847.50 / $2,354.98	Professional		$847.50	$847.50	$2,354.98
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $257.73 / $540.13 / $913.75	Professional		$257.73	$540.13	$913.75
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 $528.87 / $720.72 / $1,777.22	Professional		$528.87	$720.72	$1,777.22