Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.57 / $2,843.00 / $16,713.00	Facility		$249.57	$2,843.00	$16,713.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $23.42 / $111.56 / $693.39	Facility	52	$23.42	$111.56	$693.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.85 / $186.79 / $602.75	Professional		$44.85	$186.79	$602.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.70 / $85.71 / $85.71	Professional		$41.70	$85.71	$85.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,931.00 / $11,994.00	Facility		$2,143.00	$5,931.00	$11,994.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.48 / $148.71 / $365.63	Professional		$51.48	$148.71	$365.63
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $27,955.87	Facility		$77.09	$100.00	$27,955.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $43.47 / $130.97 / $344.79	Professional		$43.47	$130.97	$344.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $73.43 / $73.43	Facility		$73.43	$73.43	$73.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	52	$58.74	$58.74	$58.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.13 / $166.16 / $406.75	Professional		$46.13	$166.16	$406.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $46.81 / $256.89 / $363.10	Professional		$46.81	$256.89	$363.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $170.19 / $353.02	Professional		$42.13	$170.19	$353.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $373.86 / $411.84	Facility		$55.00	$373.86	$411.84
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $155.00 / $228.34 / $228.34	Facility	52	$155.00	$228.34	$228.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $759.14 / $2,111.16 / $2,111.16	Professional		$759.14	$2,111.16	$2,111.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $171.40	Professional		$32.34	$32.34	$171.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $43.40 / $141.76 / $366.25	Facility		$43.40	$141.76	$366.25
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	52	$58.74	$58.74	$58.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.16 / $170.88 / $519.09	Professional		$48.16	$170.88	$519.09
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $144.46 / $144.46 / $697.45	Professional		$144.46	$144.46	$697.45
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $267.16 / $453.54	Professional		$42.53	$267.16	$453.54
United Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,523.00 / $5,830.00	Facility		$545.00	$1,523.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $168.63 / $241.95 / $536.97	Professional		$168.63	$241.95	$536.97