Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,484.00 / $10,144.65 / $23,524.00	Facility		$3,484.00	$10,144.65	$23,524.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $4,186.00 / $4,186.00 / $4,186.00	Facility	22	$4,186.00	$4,186.00	$4,186.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,516.00 / $21,284.00 / $35,286.00	Facility	50	$6,516.00	$21,284.00	$35,286.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.67 / $515.47 / $1,876.00	Professional		$420.67	$515.47	$1,876.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $6,048.00 / $13,012.00	Facility		$2,143.00	$6,048.00	$13,012.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $509.69 / $674.68 / $1,284.43	Professional		$509.69	$674.68	$1,284.43
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $11,087.90	Facility		$66.70	$100.00	$11,087.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $285.88 / $430.96 / $1,066.51	Professional		$285.88	$430.96	$1,066.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,185.52 / $3,764.71 / $8,869.33	Facility		$3,185.52	$3,764.71	$8,869.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.69 / $542.65 / $1,618.86	Professional		$410.69	$542.65	$1,618.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $354.06 / $449.27 / $606.51	Professional		$354.06	$449.27	$606.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $404.34 / $518.50 / $943.94	Professional		$404.34	$518.50	$943.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,268.42 / $14,302.50	Facility		$55.00	$2,268.42	$14,302.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,991.20 / $3,057.36 / $3,404.25	Professional		$2,991.20	$3,057.36	$3,404.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $417.11 / $517.91 / $720.08	Facility		$417.11	$517.91	$720.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $419.65 / $550.04 / $1,221.53	Professional		$419.65	$550.04	$1,221.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,350.04 / $1,350.04 / $1,350.04	Professional		$1,350.04	$1,350.04	$1,350.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $354.06 / $495.68 / $601.90	Professional		$354.06	$495.68	$601.90
United Facility/Professional Facility Modifier Low / Median / High Price $5,478.00 / $12,341.00 / $26,672.00	Facility		$5,478.00	$12,341.00	$26,672.00
United Facility/Professional Professional Modifier Low / Median / High Price $332.91 / $523.45 / $1,463.16	Professional		$332.91	$523.45	$1,463.16