Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $603.44 / $4,858.70 / $15,877.00	Facility		$603.44	$4,858.70	$15,877.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,478.50 / $5,184.00 / $21,000.00	Facility	50	$3,478.50	$5,184.00	$21,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.76 / $504.38 / $2,122.42	Professional		$105.76	$504.38	$2,122.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $410.15 / $2,445.08 / $4,446.68	Professional	50	$410.15	$2,445.08	$4,446.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,759.00 / $4,718.00 / $9,381.00	Facility		$1,759.00	$4,718.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.73 / $891.10 / $1,794.73	Professional		$178.73	$891.10	$1,794.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $162.94 / $740.38 / $1,148.24	Professional	50	$162.94	$740.38	$1,148.24
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,367.09	Facility		$66.00	$100.00	$5,367.09
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $359.43 / $953.62	Professional		$107.34	$359.43	$953.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,212.60 / $1,433.09 / $3,376.23	Facility		$1,212.60	$1,433.09	$3,376.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $462.57 / $1,395.74	Professional		$107.66	$462.57	$1,395.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $109.79 / $434.47 / $987.05	Professional		$109.79	$434.47	$987.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $99.28 / $474.00 / $1,101.86	Professional		$99.28	$474.00	$1,101.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,042.07 / $1,042.07	Facility		$55.00	$1,042.07	$1,042.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,115.98 / $4,093.84 / $4,811.03	Professional		$2,115.98	$4,093.84	$4,811.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $113.03 / $499.24 / $959.55	Facility		$113.03	$499.24	$959.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.06 / $436.55 / $1,453.36	Professional		$112.06	$436.55	$1,453.36
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $328.75 / $328.75 / $1,909.58	Professional		$328.75	$328.75	$1,909.58
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $99.76 / $564.82 / $844.40	Professional		$99.76	$564.82	$844.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,407.00 / $2,731.00 / $7,940.00	Facility		$1,407.00	$2,731.00	$7,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $448.84 / $653.66 / $1,732.79	Professional		$448.84	$653.66	$1,732.79