Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,198.65 / $7,830.00 / $17,828.00	Facility		$1,198.65	$7,830.00	$17,828.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $308.82 / $428.18 / $3,186.41	Facility	54	$308.82	$428.18	$3,186.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $387.37 / $568.98 / $1,588.46	Professional		$387.37	$568.98	$1,588.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $359.65 / $470.37 / $830.09	Professional		$359.65	$470.37	$830.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,282.00 / $8,774.00 / $18,030.00	Facility		$2,282.00	$8,774.00	$18,030.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $435.37 / $666.66 / $1,337.84	Professional		$435.37	$666.66	$1,337.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $10,705.74	Facility		$66.70	$100.00	$10,705.74
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $415.84 / $645.74 / $1,258.63	Professional		$415.84	$645.74	$1,258.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $802.88 / $1,458.73 / $1,988.34	Facility		$802.88	$1,458.73	$1,988.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.16 / $701.26 / $1,339.94	Professional		$455.16	$701.26	$1,339.94
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $399.48 / $690.28 / $1,116.75	Professional		$399.48	$690.28	$1,116.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $471.78 / $719.92 / $1,270.19	Professional		$471.78	$719.92	$1,270.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,271.74 / $3,358.56 / $26,542.00	Facility		$3,271.74	$3,358.56	$26,542.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,513.22 / $1,708.32 / $1,708.32	Facility	54	$1,513.22	$1,708.32	$1,708.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,473.76 / $4,783.60 / $5,502.38	Professional		$3,473.76	$4,783.60	$5,502.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $484.37 / $713.84 / $1,074.89	Facility		$484.37	$713.84	$1,074.89
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,270.02 / $1,270.02 / $1,270.02	Facility	54	$1,270.02	$1,270.02	$1,270.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $475.28 / $744.41 / $1,455.41	Professional		$475.28	$744.41	$1,455.41
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $3,988.00 / $3,988.00 / $3,988.00	Facility		$3,988.00	$3,988.00	$3,988.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,570.60 / $1,570.60 / $2,207.73	Professional		$1,570.60	$1,570.60	$2,207.73
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $503.09 / $654.91 / $906.79	Professional		$503.09	$654.91	$906.79
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,384.00 / $15,471.00	Facility		$3,523.00	$7,384.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $504.84 / $651.59 / $1,657.05	Professional		$504.84	$651.59	$1,657.05