Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.00 / $2,704.00 / $14,069.00	Facility		$234.00	$2,704.00	$14,069.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,711.82 / $1,711.82 / $6,530.25	Facility	50	$1,711.82	$1,711.82	$6,530.25
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $9.72 / $20.78 / $132.46	Facility	53	$9.72	$20.78	$132.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $103.90 / $506.00	Professional		$48.18	$103.90	$506.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.93 / $122.49 / $377.53	Professional	50	$69.93	$122.49	$377.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.29 / $64.13 / $263.81	Professional		$44.29	$64.13	$263.81
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $143.94 / $143.94 / $143.94	Professional	50	$143.94	$143.94	$143.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,546.00 / $4,418.00 / $9,274.00	Facility		$1,546.00	$4,418.00	$9,274.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.65 / $79.20 / $158.02	Professional		$57.65	$79.20	$158.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $81.17 / $101.02 / $144.03	Professional	50	$81.17	$101.02	$144.03
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $4,970.60	Facility		$66.09	$100.00	$4,970.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $121.39 / $229.32	Professional		$64.53	$121.39	$229.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,277.00 / $2,277.00	Facility		$2,277.00	$2,277.00	$2,277.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $105.04 / $228.41	Professional		$58.65	$105.04	$228.41
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.08 / $133.28 / $185.38	Professional		$56.08	$133.28	$185.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.97 / $112.89 / $208.36	Professional		$50.97	$112.89	$208.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $247.48 / $354.52 / $12,000.00	Facility		$247.48	$354.52	$12,000.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $48.61 / $49.50 / $49.50	Facility	53	$48.61	$49.50	$49.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $526.00 / $2,512.54 / $2,512.54	Professional		$526.00	$2,512.54	$2,512.54
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 $58.52 / $109.36 / $209.13	Facility		$58.52	$109.36	$209.13
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $111.78 / $251.48	Professional		$60.00	$111.78	$251.48
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $628.00 / $628.00 / $628.00	Facility		$628.00	$628.00	$628.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $170.30 / $170.30 / $345.82	Professional		$170.30	$170.30	$345.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $50.97 / $124.91 / $239.91	Professional		$50.97	$124.91	$239.91
United Facility/Professional Facility Modifier Low / Median / High Price $570.00 / $1,533.00 / $6,323.00	Facility		$570.00	$1,533.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.92 / $129.59 / $263.02	Professional		$79.92	$129.59	$263.02