Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.57 / $4,702.00 / $16,125.00	Facility		$153.57	$4,702.00	$16,125.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $483.29 / $1,317.35 / $2,163.00	Facility	50	$483.29	$1,317.35	$2,163.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $103.87 / $372.20	Professional		$76.37	$103.87	$372.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $342.40 / $526.22 / $827.00	Professional	50	$342.40	$526.22	$827.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $277.45 / $277.45 / $277.45	Professional	50	$277.45	$277.45	$277.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,882.00 / $4,505.00 / $8,976.00	Facility		$1,882.00	$4,505.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $103.48 / $218.15	Professional		$65.75	$103.48	$218.15
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $132.30 / $192.56 / $262.99	Professional	50	$132.30	$192.56	$262.99
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $4,979.42	Facility		$66.00	$100.00	$4,979.42
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $75.26 / $97.94 / $223.39	Professional		$75.26	$97.94	$223.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.69 / $167.99 / $1,487.00	Facility		$167.69	$167.99	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.86 / $130.99 / $282.89	Professional		$90.86	$130.99	$282.89
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $120.49 / $209.58	Professional		$60.68	$120.49	$209.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.48 / $163.19 / $277.13	Professional		$107.48	$163.19	$277.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $485.92 / $526.91	Facility		$55.00	$485.92	$526.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $876.00 / $1,030.72 / $1,254.83	Professional		$876.00	$1,030.72	$1,254.83
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 $95.03 / $143.56 / $218.31	Facility		$95.03	$143.56	$218.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.04 / $142.31 / $297.62	Professional		$92.04	$142.31	$297.62
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $313.02 / $313.02 / $412.80	Professional		$313.02	$313.02	$412.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $84.96 / $114.79 / $193.85	Professional		$84.96	$114.79	$193.85
United Facility/Professional Facility Modifier Low / Median / High Price $526.00 / $1,523.00 / $5,830.00	Facility		$526.00	$1,523.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $90.50 / $120.58 / $303.10	Professional		$90.50	$120.58	$303.10