Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $272.56 / $3,397.44 / $14,970.00	Facility		$272.56	$3,397.44	$14,970.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $830.40 / $1,504.02 / $3,162.36	Facility	50	$830.40	$1,504.02	$3,162.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $84.74 / $487.50	Professional		$48.93	$84.74	$487.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.81 / $133.47 / $508.10	Professional	50	$72.81	$133.47	$508.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $55.58 / $94.85	Professional		$42.95	$55.58	$94.85
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 $47.83 / $70.56 / $154.25	Professional		$47.83	$70.56	$154.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $80.09 / $99.39 / $136.26	Professional	50	$80.09	$99.39	$136.26
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $100.00 / $5,117.38	Facility		$65.90	$100.00	$5,117.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $49.96 / $73.19 / $145.72	Professional		$49.96	$73.19	$145.72
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 $55.65 / $96.36 / $181.56	Professional		$55.65	$96.36	$181.56
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $75.48 / $138.03	Professional		$55.91	$75.48	$138.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.96 / $93.89 / $172.00	Professional		$50.96	$93.89	$172.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $230.12 / $247.76 / $1,700.00	Facility		$230.12	$247.76	$1,700.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $483.00 / $1,800.00 / $1,800.00	Professional		$483.00	$1,800.00	$1,800.00
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 $59.35 / $91.89 / $145.78	Facility		$59.35	$91.89	$145.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $101.20 / $217.73	Professional		$57.38	$101.20	$217.73
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $25.87 / $28.08 / $470,400.00	Professional	80	$25.87	$28.08	$470,400.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $169.10 / $169.10 / $294.12	Professional		$169.10	$169.10	$294.12
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $96.34 / $131.35	Professional		$50.79	$96.34	$131.35
United Facility/Professional Facility Modifier Low / Median / High Price $570.00 / $1,551.00 / $6,323.00	Facility		$570.00	$1,551.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.16 / $99.96 / $222.40	Professional		$69.16	$99.96	$222.40