Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $4,181.25 / $13,582.00	Facility		$550.00	$4,181.25	$13,582.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $48.57 / $148.72 / $813.09	Facility	52	$48.57	$148.72	$813.09
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.43 / $59.49 / $394.83	Facility	53	$19.43	$59.49	$394.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $285.13 / $874.81	Professional		$97.14	$285.13	$874.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.28 / $196.51 / $511.29	Professional		$92.28	$196.51	$511.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.00 / $5,357.00 / $10,576.00	Facility		$1,196.00	$5,357.00	$10,576.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.15 / $342.00 / $674.69	Professional		$117.15	$342.00	$674.69
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 $109.06 / $258.02 / $570.10	Professional		$109.06	$258.02	$570.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $766.00 / $1,698.33	Facility		$540.00	$766.00	$1,698.33
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.31 / $296.55 / $620.76	Professional		$116.31	$296.55	$620.76
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.72 / $135.78 / $493.63	Professional		$89.72	$135.78	$493.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.96 / $276.56 / $516.76	Professional		$104.96	$276.56	$516.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $599.65 / $611.20	Facility		$55.00	$599.65	$611.20
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $381.48 / $412.53 / $412.53	Facility	52	$381.48	$412.53	$412.53
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $95.37 / $103.13 / $103.13	Facility	53	$95.37	$103.13	$103.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,072.09 / $2,062.48 / $2,398.94	Professional		$1,072.09	$2,062.48	$2,398.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $240.05	Professional		$32.34	$32.34	$240.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.56 / $271.11 / $497.77	Facility		$108.56	$271.11	$497.77
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $122.56 / $302.70 / $722.93	Professional		$122.56	$302.70	$722.93
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $353.83 / $353.83 / $1,009.00	Professional		$353.83	$353.83	$1,009.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $94.38 / $129.78 / $406.52	Professional		$94.38	$129.78	$406.52
United Facility/Professional Facility Modifier Low / Median / High Price $850.11 / $3,964.00 / $9,131.00	Facility		$850.11	$3,964.00	$9,131.00
United Facility/Professional Professional Modifier Low / Median / High Price $239.68 / $349.73 / $772.41	Professional		$239.68	$349.73	$772.41