Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $625.09 / $3,747.00 / $15,234.00	Facility		$625.09	$3,747.00	$15,234.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,464.41 / $3,950.40 / $8,006.00	Facility	50	$1,464.41	$3,950.40	$8,006.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.67 / $191.25 / $608.77	Professional		$102.67	$191.25	$608.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.01 / $288.42 / $937.63	Professional	50	$154.01	$288.42	$937.63
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $252.31 / $268.69 / $331.92	Professional	50	$252.31	$268.69	$331.92
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 $98.60 / $145.46 / $329.98	Professional		$98.60	$145.46	$329.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $165.27 / $206.40 / $289.10	Professional	50	$165.27	$206.40	$289.10
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 $101.45 / $166.94 / $320.50	Professional		$101.45	$166.94	$320.50
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 $117.26 / $207.65 / $390.63	Professional		$117.26	$207.65	$390.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $193.00 / $323.38	Professional		$120.20	$193.00	$323.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.18 / $200.20 / $368.80	Professional		$108.18	$200.20	$368.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $478.34 / $524.02 / $30,000.00	Facility		$478.34	$524.02	$30,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,012.00 / $3,500.00 / $3,500.00	Professional		$1,012.00	$3,500.00	$3,500.00
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 $124.97 / $196.06 / $314.68	Facility		$124.97	$196.06	$314.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $215.94 / $459.65	Professional		$118.69	$215.94	$459.65
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 $346.32 / $346.32 / $632.42	Professional		$346.32	$346.32	$632.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $109.24 / $209.08 / $289.50	Professional		$109.24	$209.08	$289.50
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 $146.61 / $211.86 / $454.59	Professional		$146.61	$211.86	$454.59