Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $3,981.07 / $12,589.25	Facility		$1,202.26	$3,981.07	$12,589.25
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility	52	$1,862.09	$1,862.09	$1,862.09
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility	53	$2,454.71	$2,454.71	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $229.09 / $851.14	Professional		$81.28	$229.09	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $131.83 / $194.98	Professional		$72.44	$131.83	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,466.84 / $12,882.50	Facility		$2,511.89	$4,466.84	$12,882.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $251.19 / $537.03	Professional		$100.00	$251.19	$537.03
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $1,047.13 / $5,754.40	Facility		$66.07	$1,047.13	$5,754.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $269.15 / $512.86	Professional		$95.50	$269.15	$512.86
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 $97.72 / $239.88 / $489.78	Professional		$97.72	$239.88	$489.78
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $239.88 / $380.19	Professional		$79.43	$239.88	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $194.98 / $346.74	Professional		$72.44	$194.98	$346.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,089.30	Facility		$54.95	$56.23	$2,089.30
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Facility	52	$1,698.24	$1,698.24	$1,698.24
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 $1,584.89 / $1,819.70 / $1,819.70	Professional		$1,584.89	$1,819.70	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $309.03	Professional		$181.97	$181.97	$309.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $204.17 / $363.08	Facility		$83.18	$204.17	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $234.42 / $512.86	Professional		$93.33	$234.42	$512.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $870.96	Professional		$288.40	$288.40	$870.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $239.88 / $407.38	Professional		$72.44	$239.88	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,951.21 / $7,943.28	Facility		$1,479.11	$2,951.21	$7,943.28
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $213.80 / $446.68	Professional		$83.18	$213.80	$446.68