Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $4,344.83 / $16,109.00	Facility		$365.00	$4,344.83	$16,109.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $695.56 / $4,296.00 / $8,245.00	Facility	50	$695.56	$4,296.00	$8,245.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.83 / $157.80 / $613.49	Professional		$130.83	$157.80	$613.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $217.52 / $597.48 / $993.59	Professional	50	$217.52	$597.48	$993.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.63 / $263.95 / $344.68	Professional	50	$100.63	$263.95	$344.68
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 $158.47 / $235.62 / $411.22	Professional		$158.47	$235.62	$411.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $168.50 / $212.22 / $263.97	Professional	50	$168.50	$212.22	$263.97
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 $125.93 / $179.90 / $369.49	Professional		$125.93	$179.90	$369.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.63 / $155.91 / $1,487.00	Facility		$155.63	$155.91	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.02 / $176.75 / $334.33	Professional		$131.02	$176.75	$334.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $141.01 / $199.50	Professional		$83.40	$141.01	$199.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.79 / $167.68 / $289.66	Professional		$121.79	$167.68	$289.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $559.12 / $605.05	Facility		$55.00	$559.12	$605.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,415.00 / $1,528.92 / $1,721.89	Professional		$1,415.00	$1,528.92	$1,721.89
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 $141.22 / $178.34 / $266.00	Facility		$141.22	$178.34	$266.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $132.94 / $188.10 / $335.92	Professional		$132.94	$188.10	$335.92
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $380.65 / $380.65 / $437.15	Professional		$380.65	$380.65	$437.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $144.78 / $184.61	Professional		$113.84	$144.78	$184.61
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 $105.56 / $160.44 / $303.97	Professional		$105.56	$160.44	$303.97