Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.19 / $4,344.83 / $16,008.00	Facility		$349.19	$4,344.83	$16,008.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,427.00 / $5,427.00 / $5,427.00	Facility	50	$5,427.00	$5,427.00	$5,427.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.95 / $174.88 / $477.45	Professional		$71.95	$174.88	$477.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,085.16 / $1,085.16 / $1,085.16	Professional	50	$1,085.16	$1,085.16	$1,085.16
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 $67.80 / $100.03 / $236.13	Professional		$67.80	$100.03	$236.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.68 / $167.71 / $304.67	Professional	50	$107.68	$167.71	$304.67
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 $80.81 / $176.27 / $364.14	Professional		$80.81	$176.27	$364.14
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 $82.19 / $198.62 / $423.95	Professional		$82.19	$198.62	$423.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $83.77 / $123.11 / $393.84	Professional		$83.77	$123.11	$393.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.49 / $227.10 / $441.58	Professional		$88.49	$227.10	$441.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $386.01 / $426.22 / $12,000.00	Facility		$386.01	$426.22	$12,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,998.00 / $1,998.00 / $1,998.00	Professional		$1,998.00	$1,998.00	$1,998.00
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 $85.56 / $188.90 / $364.66	Facility		$85.56	$188.90	$364.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $82.34 / $209.75 / $472.31	Professional		$82.34	$209.75	$472.31
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 $272.11 / $272.11 / $718.11	Professional		$272.11	$272.11	$718.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $87.87 / $137.33 / $324.37	Professional		$87.87	$137.33	$324.37
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $2,699.00 / $7,655.00	Facility		$1,120.00	$2,699.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $162.52 / $209.53 / $496.84	Professional		$162.52	$209.53	$496.84