Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $3,363.00 / $15,572.00	Facility		$72.70	$3,363.00	$15,572.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.26 / $66.18 / $252.42	Professional		$29.26	$66.18	$252.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $47.54 / $55.89	Professional		$47.54	$47.54	$55.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,505.00 / $9,119.00	Facility		$1,723.00	$4,505.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.80 / $64.94 / $130.41	Professional		$29.80	$64.94	$130.41
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.05 / $100.00 / $356.35	Facility		$76.05	$100.00	$356.35
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $29.65 / $68.76 / $126.00	Professional		$29.65	$68.76	$126.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $56.93 / $137.35	Professional		$28.39	$56.93	$137.35
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $64.01 / $138.50	Professional		$27.18	$64.01	$138.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.91 / $45.00 / $80.81	Professional		$24.91	$45.00	$80.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $113.54 / $121.27	Facility		$55.00	$113.54	$121.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.00 / $427.97 / $440.80	Professional		$263.00	$427.97	$440.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $27.34 / $44.38 / $94.77	Facility		$27.34	$44.38	$94.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $60.09 / $128.00	Professional		$28.94	$60.09	$128.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $84.41 / $146.91	Professional		$84.41	$84.41	$146.91
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.16 / $109.83 / $193.90	Professional		$30.16	$109.83	$193.90
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,551.00 / $6,920.00	Facility		$548.00	$1,551.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $63.13 / $152.32	Professional		$37.11	$63.13	$152.32