Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $3,548.13 / $13,803.84	Facility		$549.54	$3,548.13	$13,803.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $831.76 / $1,513.56 / $5,128.61	Facility	50	$831.76	$1,513.56	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $588.84	Professional		$48.98	$102.33	$588.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $141.25 / $537.03	Professional	50	$74.13	$141.25	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $81.28 / $154.88	Professional		$40.74	$81.28	$154.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $125.89 / $257.04	Professional	50	$72.44	$125.89	$257.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,466.84 / $12,882.50	Facility		$2,570.40	$4,466.84	$12,882.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $87.10 / $181.97	Professional		$51.29	$87.10	$181.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $70.79 / $112.20 / $154.88	Professional	50	$70.79	$112.20	$154.88
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $223.87 / $5,888.44	Facility		$64.57	$223.87	$5,888.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $162.18	Professional		$51.29	$81.28	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $95.50 / $177.83	Professional		$56.23	$95.50	$177.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $72.44 / $147.91	Professional		$48.98	$72.44	$147.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $100.00 / $186.21	Professional		$44.67	$100.00	$186.21
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,479.11 / $1,698.24	Facility		$741.31	$1,479.11	$1,698.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $128.82	Professional		$75.86	$75.86	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $95.50 / $165.96	Facility		$52.48	$95.50	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $100.00 / $186.21	Professional		$57.54	$100.00	$186.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $295.12	Professional		$169.82	$169.82	$295.12
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $104.71 / $138.04	Professional		$44.67	$104.71	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,584.89 / $6,456.54	Facility		$588.84	$1,584.89	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $75.86 / $158.49	Professional		$44.67	$75.86	$158.49