Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $4,848.00 / $16,713.00	Facility		$365.00	$4,848.00	$16,713.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,122.50 / $4,122.50 / $5,940.00	Facility	50	$4,122.50	$4,122.50	$5,940.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.83 / $137.19 / $404.33	Professional		$78.83	$137.19	$404.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Professional		$200.00	$200.00	$200.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,464.00 / $8,976.00	Facility		$1,723.00	$4,464.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $179.95 / $429.40	Professional		$128.44	$179.95	$429.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $122.55 / $163.21 / $229.26	Professional	50	$122.55	$163.21	$229.26
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $4,979.42	Facility		$66.00	$100.00	$4,979.42
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $91.06 / $151.37 / $278.99	Professional		$91.06	$151.37	$278.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $730.06 / $1,307.57	Facility		$56.00	$730.06	$1,307.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.61 / $155.94 / $303.81	Professional		$89.61	$155.94	$303.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $131.41 / $213.89	Professional		$82.25	$131.41	$213.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.16 / $138.46 / $255.53	Professional		$76.16	$138.46	$255.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $349.69 / $370.50	Facility		$55.00	$349.69	$370.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $568.40 / $964.40 / $1,099.13	Professional		$568.40	$964.40	$1,099.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.33 / $134.30 / $213.01	Facility		$89.33	$134.30	$213.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.47 / $163.78 / $330.66	Professional		$91.47	$163.78	$330.66
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $250.87 / $250.87 / $434.80	Professional		$250.87	$250.87	$434.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $131.41 / $197.13	Professional		$74.70	$131.41	$197.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,699.00 / $7,655.00	Facility		$1,371.00	$2,699.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $154.04 / $295.81	Professional		$105.00	$154.04	$295.81