Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $341.78 / $3,363.00 / $13,916.00	Facility		$341.78	$3,363.00	$13,916.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $67.76 / $116.70 / $682.76	Facility	52	$67.76	$116.70	$682.76
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.10 / $46.68 / $273.10	Facility	53	$27.10	$46.68	$273.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.54 / $274.83 / $934.83	Professional		$123.54	$274.83	$934.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $59.80 / $116.70 / $566.03	Professional	52	$59.80	$116.70	$566.03
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $23.92 / $43.42 / $186.97	Professional	53	$23.92	$43.42	$186.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $392.38 / $392.38 / $1,162.97	Professional		$392.38	$392.38	$1,162.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,769.00 / $11,233.00	Facility		$2,143.00	$5,769.00	$11,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.28 / $234.70 / $518.12	Professional		$135.28	$234.70	$518.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $5,122.07	Facility		$66.70	$100.00	$5,122.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.32 / $216.17 / $440.70	Professional		$125.32	$216.17	$440.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $399.11 / $471.68 / $1,111.23	Facility		$399.11	$471.68	$1,111.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.90 / $220.75 / $599.34	Professional		$110.90	$220.75	$599.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $105.18 / $336.52	Professional		$86.75	$105.18	$336.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $219.65 / $414.90	Professional		$79.86	$219.65	$414.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $388.79 / $407.55 / $12,000.00	Facility		$388.79	$407.55	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $199.29 / $311.02 / $311.02	Facility	52	$199.29	$311.02	$311.02
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $40.86 / $77.76 / $77.76	Facility	53	$40.86	$77.76	$77.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $846.46 / $1,582.80 / $1,848.00	Professional		$846.46	$1,582.80	$1,848.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $96.48 / $201.52 / $363.32	Facility		$96.48	$201.52	$363.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.03 / $226.25 / $598.57	Professional		$116.03	$226.25	$598.57
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,230.00 / $1,230.00 / $1,230.00	Facility		$1,230.00	$1,230.00	$1,230.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $262.42 / $262.42 / $702.41	Professional		$262.42	$262.42	$702.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $109.39 / $311.74	Professional		$70.76	$109.39	$311.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,350.00 / $2,741.00 / $9,380.00	Facility		$1,350.00	$2,741.00	$9,380.00
United Facility/Professional Professional Modifier Low / Median / High Price $172.94 / $269.55 / $731.60	Professional		$172.94	$269.55	$731.60