Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $546.00 / $4,399.50 / $15,747.00	Facility		$546.00	$4,399.50	$15,747.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,545.34 / $2,545.34 / $5,953.12	Facility	50	$2,545.34	$2,545.34	$5,953.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.34 / $240.42 / $753.88	Professional		$119.34	$240.42	$753.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $171.84 / $556.23 / $2,121.00	Professional	50	$171.84	$556.23	$2,121.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.51 / $144.51 / $144.51	Professional		$144.51	$144.51	$144.51
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 $109.83 / $154.71 / $328.79	Professional		$109.83	$154.71	$328.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $175.02 / $256.19 / $340.59	Professional	50	$175.02	$256.19	$340.59
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $4,886.39	Facility		$66.90	$100.00	$4,886.39
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $117.95 / $242.79 / $465.42	Professional		$117.95	$242.79	$465.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $938.60 / $940.26 / $1,681.08	Facility		$938.60	$940.26	$1,681.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.81 / $276.83 / $519.29	Professional		$135.81	$276.83	$519.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $148.79 / $194.84 / $448.73	Professional		$148.79	$194.84	$448.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $272.79 / $503.88	Professional		$134.66	$272.79	$503.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $593.41 / $649.37 / $32,000.00	Facility		$593.41	$649.37	$32,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,262.00 / $1,990.16 / $2,209.19	Professional		$1,262.00	$1,990.16	$2,209.19
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 $131.69 / $258.24 / $461.02	Facility		$131.69	$258.24	$461.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $136.71 / $293.58 / $590.52	Professional		$136.71	$293.58	$590.52
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,526.00 / $1,526.00 / $1,526.00	Facility		$1,526.00	$1,526.00	$1,526.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $429.50 / $429.50 / $849.05	Professional		$429.50	$429.50	$849.05
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $253.30 / $369.51	Professional		$135.22	$253.30	$369.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,207.00 / $2,699.00 / $7,655.00	Facility		$1,207.00	$2,699.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.77 / $283.14 / $594.30	Professional		$197.77	$283.14	$594.30