Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $6,025.60 / $16,982.44	Facility		$1,737.80	$6,025.60	$16,982.44
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	52	$446.68	$446.68	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $371.54	Professional		$57.54	$79.43	$371.54
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 $75.86 / $125.89 / $269.15	Professional		$75.86	$125.89	$269.15
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $1,096.48 / $5,754.40	Facility		$66.07	$1,096.48	$5,754.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $208.93	Professional		$83.18	$114.82	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $223.87	Professional		$69.18	$112.20	$223.87
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $138.04	Professional		$67.61	$91.20	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $338.84	Professional		$57.54	$75.86	$338.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,691.53	Facility		$54.95	$56.23	$2,691.53
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility	52	$2,187.76	$2,187.76	$2,187.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $93.33 / $199.53	Facility		$64.57	$93.33	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $208.93	Professional		$69.18	$114.82	$208.93
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $128.82 / $194.98	Professional		$61.66	$128.82	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,884.03 / $7,943.28	Facility		$1,445.44	$2,884.03	$7,943.28
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $83.18 / $190.55	Professional		$50.12	$83.18	$190.55