Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,390.35 / $6,211.00 / $17,809.00	Facility		$1,390.35	$6,211.00	$17,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $415.20 / $510.74 / $2,157.00	Professional		$415.20	$510.74	$2,157.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.79 / $315.79 / $315.79	Professional		$315.79	$315.79	$315.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,400.00	Facility		$2,137.00	$5,863.00	$11,400.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $626.51 / $790.77 / $1,490.80	Professional		$626.51	$790.77	$1,490.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,919.63	Facility		$66.00	$100.00	$6,919.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $362.20 / $520.90 / $1,182.78	Professional		$362.20	$520.90	$1,182.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,816.42 / $1,819.64 / $3,253.30	Facility		$1,816.42	$1,819.64	$3,253.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $471.35 / $623.53 / $1,377.29	Professional		$471.35	$623.53	$1,377.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $446.76 / $614.82 / $845.10	Professional		$446.76	$614.82	$845.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $497.48 / $681.95 / $1,216.05	Professional		$497.48	$681.95	$1,216.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,897.68 / $5,246.20 / $16,394.00	Facility		$1,897.68	$5,246.20	$16,394.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $118.06 / $497.27 / $497.27	Facility	AS	$118.06	$497.27	$497.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,389.20 / $5,389.20 / $5,389.20	Professional		$5,389.20	$5,389.20	$5,389.20
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 $526.62 / $670.81 / $983.71	Facility		$526.62	$670.81	$983.71
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $191.82 / $191.82 / $191.82	Facility	80	$191.82	$191.82	$191.82
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $57.68 / $57.68 / $163.05	Facility	AS	$57.68	$57.68	$163.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $471.35 / $649.21 / $1,341.23	Professional		$471.35	$649.21	$1,341.23
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,646.31 / $1,646.31 / $1,646.31	Professional		$1,646.31	$1,646.31	$1,646.31
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $496.65 / $670.14 / $845.10	Professional		$496.65	$670.14	$845.10
United Facility/Professional Facility Modifier Low / Median / High Price $3,459.00 / $7,335.00 / $14,743.00	Facility		$3,459.00	$7,335.00	$14,743.00
United Facility/Professional Professional Modifier Low / Median / High Price $391.19 / $513.72 / $1,126.22	Professional		$391.19	$513.72	$1,126.22