Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $3,981.07 / $12,589.25	Facility		$794.33	$3,981.07	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $239.88 / $891.25	Professional		$93.33	$239.88	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $186.21 / $323.59	Professional		$87.10	$186.21	$323.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,466.84 / $12,022.64	Facility		$2,570.40	$4,466.84	$12,022.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $269.15 / $691.83	Professional		$144.54	$269.15	$691.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $1,318.26 / $5,623.41	Facility		$66.07	$1,318.26	$5,623.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $263.03 / $501.19	Professional		$104.71	$263.03	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $251.19 / $478.63	Professional		$109.65	$251.19	$478.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $218.78 / $489.78	Professional		$102.33	$218.78	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $263.03 / $549.54	Professional		$91.20	$263.03	$549.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,951.21	Facility		$54.95	$56.23	$2,951.21
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	53	$426.58	$426.58	$426.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,137.96 / $2,137.96	Professional		$1,819.70	$2,137.96	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $354.81	Professional		$213.80	$263.03	$354.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $239.88 / $467.74	Facility		$104.71	$239.88	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $251.19 / $537.03	Professional		$109.65	$251.19	$537.03
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $851.14	Professional		$323.59	$323.59	$851.14
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $295.12 / $398.11	Professional		$93.33	$295.12	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $3,019.95 / $7,585.78	Facility		$1,479.11	$3,019.95	$7,585.78
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $204.17 / $398.11	Professional		$87.10	$204.17	$398.11