Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $648.75 / $3,521.00 / $13,171.00	Facility		$648.75	$3,521.00	$13,171.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $144.86 / $259.83 / $1,185.61	Facility	52	$144.86	$259.83	$1,185.61
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $57.94 / $103.93 / $474.25	Facility	53	$57.94	$103.93	$474.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.14 / $455.43 / $1,305.52	Professional		$263.14	$455.43	$1,305.52
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $51.93 / $96.63 / $297.58	Professional	53	$51.93	$96.63	$297.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $206.76 / $241.31 / $883.08	Professional		$206.76	$241.31	$883.08
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $225.18 / $225.18 / $467.38	Professional	53	$225.18	$225.18	$467.38
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 $354.44 / $546.79 / $1,095.10	Professional		$354.44	$546.79	$1,095.10
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 $317.37 / $553.57 / $1,048.49	Professional		$317.37	$553.57	$1,048.49
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 $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.77 / $511.04 / $984.86	Professional		$295.77	$511.04	$984.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $278.13 / $420.33 / $744.17	Professional		$278.13	$420.33	$744.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $250.20 / $456.83 / $826.86	Professional		$250.20	$456.83	$826.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,425.30 / $1,462.80 / $16,394.00	Facility		$1,425.30	$1,462.80	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $909.50 / $982.11 / $982.11	Facility	52	$909.50	$982.11	$982.11
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $227.37 / $245.53 / $245.53	Facility	53	$227.37	$245.53	$245.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,906.00 / $3,439.23 / $3,762.00	Professional		$1,906.00	$3,439.23	$3,762.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $380.66	Professional		$32.34	$32.34	$380.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $292.55 / $488.25 / $815.07	Facility		$292.55	$488.25	$815.07
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.14 / $561.40 / $1,125.05	Professional		$302.14	$561.40	$1,125.05
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 $831.76 / $831.76 / $1,471.31	Professional		$831.76	$831.76	$1,471.31
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $252.83 / $501.18 / $706.60	Professional		$252.83	$501.18	$706.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,761.00 / $3,965.00 / $12,135.00	Facility		$1,761.00	$3,965.00	$12,135.00
United Facility/Professional Professional Modifier Low / Median / High Price $367.44 / $540.27 / $1,115.80	Professional		$367.44	$540.27	$1,115.80