Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $700.29 / $5,947.00 / $17,030.00	Facility		$700.29	$5,947.00	$17,030.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,286.50 / $7,324.00 / $13,136.41	Facility	50	$3,286.50	$7,324.00	$13,136.41
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $79.15 / $283.69 / $1,494.35	Facility	52	$79.15	$283.69	$1,494.35
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $31.66 / $113.48 / $597.74	Facility	53	$31.66	$113.48	$597.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.13 / $239.44 / $899.79	Professional		$129.13	$239.44	$899.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $108.25 / $596.76 / $3,524.48	Professional	50	$108.25	$596.76	$3,524.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.07 / $127.07 / $127.07	Professional		$127.07	$127.07	$127.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $5,944.00 / $13,012.00	Facility		$2,143.00	$5,944.00	$13,012.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.05 / $501.61 / $1,145.80	Professional		$177.05	$501.61	$1,145.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $253.23 / $591.41 / $784.43	Professional	50	$253.23	$591.41	$784.43
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $7,340.45	Facility		$66.70	$100.00	$7,340.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $161.36 / $404.45 / $946.22	Professional		$161.36	$404.45	$946.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,091.14 / $2,471.35 / $5,822.29	Facility		$2,091.14	$2,471.35	$5,822.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.30 / $417.76 / $1,131.09	Professional		$160.30	$417.76	$1,131.09
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $171.75 / $520.65 / $833.27	Professional		$171.75	$520.65	$833.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.63 / $386.84 / $702.75	Professional		$155.63	$386.84	$702.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $718.52 / $969.57 / $16,394.00	Facility		$718.52	$969.57	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $316.89 / $606.59 / $775.66	Facility	52	$316.89	$606.59	$775.66
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $79.23 / $151.65 / $193.91	Facility	53	$79.23	$151.65	$193.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,561.00 / $4,483.93 / $4,871.00	Professional		$1,561.00	$4,483.93	$4,871.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $180.97 / $367.50 / $846.99	Facility		$180.97	$367.50	$846.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $164.18 / $417.76 / $1,098.86	Professional		$164.18	$417.76	$1,098.86
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $4,577.00 / $4,577.00 / $4,577.00	Facility		$4,577.00	$4,577.00	$4,577.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $504.23 / $504.23 / $1,524.86	Professional		$504.23	$504.23	$1,524.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $190.66 / $526.12 / $991.14	Professional		$190.66	$526.12	$991.14
United Facility/Professional Facility Modifier Low / Median / High Price $3,610.00 / $7,402.00 / $16,148.00	Facility		$3,610.00	$7,402.00	$16,148.00
United Facility/Professional Professional Modifier Low / Median / High Price $362.60 / $552.23 / $1,540.03	Professional		$362.60	$552.23	$1,540.03