Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $3,715.35 / $12,302.69	Facility		$676.08	$3,715.35	$12,302.69
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,862.09 / $4,570.88 / $9,332.54	Facility	50	$1,862.09	$4,570.88	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $269.15 / $1,122.02	Professional		$100.00	$269.15	$1,122.02
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $141.25 / $190.55	Professional	22	$141.25	$141.25	$190.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $363.08 / $1,445.44	Professional	50	$147.91	$363.08	$1,445.44
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $47.86 / $138.04 / $186.21	Professional	53	$47.86	$138.04	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $371.54	Professional		$109.65	$213.80	$371.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $323.59 / $851.14	Professional	50	$158.49	$323.59	$851.14
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 $100.00 / $144.54 / $389.05	Professional		$100.00	$144.54	$389.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $245.47 / $588.84	Professional	50	$154.88	$245.47	$588.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $1,348.96 / $5,623.41	Facility		$66.07	$1,348.96	$5,623.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $269.15 / $537.03	Professional		$104.71	$269.15	$537.03
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 $114.82 / $245.47 / $478.63	Professional		$114.82	$245.47	$478.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $154.88 / $467.74	Professional		$114.82	$154.88	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $269.15 / $524.81	Professional		$102.33	$269.15	$524.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $32,359.37	Facility		$2,691.53	$2,691.53	$32,359.37
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	53	$537.03	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,073.80	Professional		$4,073.80	$4,073.80	$4,073.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $338.84	Professional		$204.17	$204.17	$338.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $239.88 / $489.78	Facility		$112.20	$239.88	$489.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $251.19 / $501.19	Professional		$114.82	$251.19	$501.19
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility		$1,513.56	$1,513.56	$1,513.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $794.33	Professional		$363.08	$363.08	$794.33
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $234.42 / $323.59	Professional		$104.71	$234.42	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,754.23 / $7,585.78	Facility		$1,479.11	$2,754.23	$7,585.78
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $194.98 / $416.87	Professional		$95.50	$194.98	$416.87