Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $564.70 / $5,068.00 / $15,877.00	Facility		$564.70	$5,068.00	$15,877.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,744.64 / $4,471.60 / $4,647.75	Facility	50	$1,744.64	$4,471.60	$4,647.75
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $193.92 / $241.97 / $1,146.65	Facility	54	$193.92	$241.97	$1,146.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.19 / $304.45 / $856.00	Professional		$237.19	$304.45	$856.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $416.31 / $587.26 / $1,995.00	Professional	50	$416.31	$587.26	$1,995.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $170.18 / $222.13 / $982.08	Professional	54	$170.18	$222.13	$982.08
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $31.33 / $43.00 / $180.60	Professional	55	$31.33	$43.00	$180.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.60 / $221.13 / $450.23	Professional		$183.60	$221.13	$450.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $348.46 / $348.46 / $348.46	Professional	50	$348.46	$348.46	$348.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,546.00 / $4,465.00 / $8,976.00	Facility		$1,546.00	$4,465.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.45 / $435.20 / $770.37	Professional		$269.45	$435.20	$770.37
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $313.30 / $379.88 / $480.00	Professional	50	$313.30	$379.88	$480.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,021.77	Facility		$66.00	$100.00	$5,021.77
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $239.06 / $341.52 / $730.68	Professional		$239.06	$341.52	$730.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $185.80 / $253.25 / $555.00	Facility		$185.80	$253.25	$555.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.78 / $344.19 / $606.75	Professional		$236.78	$344.19	$606.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $215.56 / $288.19 / $382.62	Professional		$215.56	$288.19	$382.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $198.30 / $274.97 / $486.34	Professional		$198.30	$274.97	$486.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,395.96 / $1,436.04	Facility		$55.00	$1,395.96	$1,436.04
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $645.34 / $720.56 / $720.56	Facility	54	$645.34	$720.56	$720.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,680.00 / $4,509.17 / $4,509.17	Professional		$3,680.00	$4,509.17	$4,509.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $247.38 / $359.68 / $649.19	Facility		$247.38	$359.68	$649.19
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $461.24 / $461.24 / $461.24	Facility	54	$461.24	$461.24	$461.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $246.41 / $363.24 / $649.30	Professional		$246.41	$363.24	$649.30
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $364.74 / $454.35 / $545.67	Professional	54	$364.74	$454.35	$545.67
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $91.19 / $113.59 / $136.41	Professional	55	$91.19	$113.59	$136.41
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $677.83 / $677.83 / $812.47	Professional		$677.83	$677.83	$812.47
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $215.56 / $271.83 / $407.76	Professional		$215.56	$271.83	$407.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,046.00 / $2,699.00 / $7,655.00	Facility		$1,046.00	$2,699.00	$7,655.00
United Facility/Professional Professional Modifier Low / Median / High Price $201.82 / $279.60 / $615.13	Professional		$201.82	$279.60	$615.13