Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $486.57 / $3,525.91 / $13,171.00	Facility		$486.57	$3,525.91	$13,171.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,863.39 / $3,016.50 / $8,298.04	Facility	50	$1,863.39	$3,016.50	$8,298.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.02 / $47.56 / $305.79	Facility	53	$19.02	$47.56	$305.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.56 / $237.80 / $935.09	Professional		$94.56	$237.80	$935.09
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.84 / $374.54 / $2,074.50	Professional	50	$141.84	$374.54	$2,074.50
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $19.02 / $44.34 / $167.53	Professional	53	$19.02	$44.34	$167.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.16 / $143.84 / $591.28	Professional		$99.16	$143.84	$591.28
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $167.76 / $321.54 / $343.48	Professional	50	$167.76	$321.54	$343.48
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 $95.82 / $134.19 / $328.59	Professional		$95.82	$134.19	$328.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $154.11 / $219.22 / $312.10	Professional	50	$154.11	$219.22	$312.10
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 $102.75 / $219.33 / $449.66	Professional		$102.75	$219.33	$449.66
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 $114.63 / $249.01 / $483.90	Professional		$114.63	$249.01	$483.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $127.46 / $172.07 / $418.07	Professional		$127.46	$172.07	$418.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.02 / $252.19 / $469.50	Professional		$115.02	$252.19	$469.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $504.08 / $554.14 / $32,000.00	Facility		$504.08	$554.14	$32,000.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $100.82 / $110.83 / $110.83	Facility	53	$100.82	$110.83	$110.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,052.00 / $4,050.50 / $4,050.50	Professional		$1,052.00	$4,050.50	$4,050.50
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 $119.31 / $235.49 / $441.26	Facility		$119.31	$235.49	$441.26
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $37.61 / $37.61 / $37.61	Facility	53	$37.61	$37.61	$37.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $115.48 / $259.20 / $519.16	Professional		$115.48	$259.20	$519.16
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 $366.35 / $366.35 / $789.51	Professional		$366.35	$366.35	$789.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $115.86 / $234.98 / $344.30	Professional		$115.86	$234.98	$344.30
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 $182.07 / $267.17 / $544.11	Professional		$182.07	$267.17	$544.11