Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.04 / $3,340.00 / $14,069.00	Facility		$245.04	$3,340.00	$14,069.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,822.72 / $3,016.50 / $7,648.00	Facility	50	$1,822.72	$3,016.50	$7,648.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.89 / $171.49 / $535.70	Professional		$86.89	$171.49	$535.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.02 / $271.77 / $1,008.41	Professional	50	$123.02	$271.77	$1,008.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.37 / $100.75 / $164.67	Professional		$50.37	$100.75	$164.67
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $116.78 / $137.38 / $681.60	Professional	50	$116.78	$137.38	$681.60
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 $83.55 / $123.27 / $290.94	Professional		$83.55	$123.27	$290.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $140.31 / $177.43 / $263.18	Professional	50	$140.31	$177.43	$263.18
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 $87.14 / $151.63 / $284.49	Professional		$87.14	$151.63	$284.49
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 $99.08 / $187.45 / $353.67	Professional		$99.08	$187.45	$353.67
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $103.99 / $173.34 / $300.87	Professional		$103.99	$173.34	$300.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.59 / $183.16 / $341.93	Professional		$93.59	$183.16	$341.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $413.29 / $452.96 / $30,000.00	Facility		$413.29	$452.96	$30,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $3,100.00 / $3,100.00	Professional		$776.25	$3,100.00	$3,100.00
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 $107.86 / $179.76 / $290.30	Facility		$107.86	$179.76	$290.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $194.13 / $420.94	Professional		$101.50	$194.13	$420.94
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $51.53 / $54.29 / $470,400.00	Professional	80	$51.53	$54.29	$470,400.00
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 $295.30 / $295.30 / $577.80	Professional		$295.30	$295.30	$577.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $94.50 / $190.95 / $260.01	Professional		$94.50	$190.95	$260.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,699.00 / $7,399.00	Facility		$1,371.00	$2,699.00	$7,399.00
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $195.16 / $418.45	Professional		$138.04	$195.16	$418.45