Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,284.25 / $9,163.74 / $20,509.00	Facility		$3,284.25	$9,163.74	$20,509.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,835.00 / $11,337.00 / $26,331.01	Facility	50	$5,835.00	$11,337.00	$26,331.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $440.05 / $681.58 / $2,396.00	Professional		$440.05	$681.58	$2,396.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $435.24 / $503.77 / $1,059.22	Professional		$435.24	$503.77	$1,059.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $8,441.00 / $18,150.00	Facility		$1,800.00	$8,441.00	$18,150.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $500.59 / $649.62 / $1,330.09	Professional		$500.59	$649.62	$1,330.09
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $100.00 / $9,393.00	Facility		$69.80	$100.00	$9,393.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $361.69 / $536.38 / $1,267.66	Professional		$361.69	$536.38	$1,267.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $2,364.98 / $5,927.32	Facility		$633.00	$2,364.98	$5,927.32
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $58.98 / $58.98 / $58.98	Facility	AS	$58.98	$58.98	$58.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.55 / $649.69 / $1,401.26	Professional		$456.55	$649.69	$1,401.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $344.01 / $583.72 / $788.02	Professional		$344.01	$583.72	$788.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.65 / $638.72 / $1,182.00	Professional		$489.65	$638.72	$1,182.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $75.77 / $95.55 / $500.00	Professional	80	$75.77	$95.55	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $75.77 / $75.77 / $95.55	Professional	AS	$75.77	$75.77	$95.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,459.30 / $9,558.29 / $26,542.00	Facility		$2,459.30	$9,558.29	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $116.52 / $905.99 / $905.99	Facility	AS	$116.52	$905.99	$905.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,067.23 / $4,201.45 / $4,550.47	Professional		$4,067.23	$4,201.45	$4,550.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $767.57	Professional		$32.34	$32.34	$767.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $508.90 / $661.95 / $1,025.00	Facility		$508.90	$661.95	$1,025.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $201.20 / $201.20 / $201.20	Facility	80	$201.20	$201.20	$201.20
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $58.98 / $58.98 / $171.02	Facility	AS	$58.98	$58.98	$171.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $476.31 / $686.35 / $1,401.26	Professional		$476.31	$686.35	$1,401.26
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $5,930.00 / $5,930.00 / $5,930.00	Facility		$5,930.00	$5,930.00	$5,930.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,678.75 / $1,678.75 / $1,678.75	Professional		$1,678.75	$1,678.75	$1,678.75
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $344.01 / $529.47 / $647.13	Professional		$344.01	$529.47	$647.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,397.00 / $8,960.00 / $20,988.00	Facility		$1,397.00	$8,960.00	$20,988.00
United Facility/Professional Professional Modifier Low / Median / High Price $421.29 / $562.96 / $1,259.71	Professional		$421.29	$562.96	$1,259.71