Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,616.00 / $8,544.00 / $18,630.00	Facility		$2,616.00	$8,544.00	$18,630.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $656.66 / $708.96 / $4,331.03	Facility	54	$656.66	$708.96	$4,331.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $459.00 / $875.54 / $1,651.46	Professional		$459.00	$875.54	$1,651.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $563.66 / $563.66 / $706.24	Professional		$563.66	$563.66	$706.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,546.00 / $4,785.00 / $10,404.00	Facility		$1,546.00	$4,785.00	$10,404.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,082.24 / $1,424.23 / $2,788.02	Professional		$1,082.24	$1,424.23	$2,788.02
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $7,343.60	Facility		$66.00	$100.00	$7,343.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $822.72 / $1,175.32 / $2,662.89	Professional		$822.72	$1,175.32	$2,662.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $2,977.65 / $4,058.71	Facility		$705.31	$2,977.65	$4,058.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $841.30 / $1,244.52 / $2,550.81	Professional		$841.30	$1,244.52	$2,550.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $750.49 / $900.59 / $2,936.36	Professional		$750.49	$900.59	$2,936.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $586.46 / $781.23 / $1,536.00	Professional		$586.46	$781.23	$1,536.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,390.72 / $11,879.05	Facility		$55.00	$3,390.72	$11,879.05
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,005.66 / $7,881.75 / $7,881.75	Facility	54	$1,005.66	$7,881.75	$7,881.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,714.27 / $4,714.27 / $5,129.03	Professional		$4,714.27	$4,714.27	$5,129.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $668.80 / $869.44 / $1,520.00	Facility		$668.80	$869.44	$1,520.00
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,412.64 / $1,412.64 / $1,412.64	Facility	54	$1,412.64	$1,412.64	$1,412.64
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $282.52 / $282.52 / $282.52	Facility	80	$282.52	$282.52	$282.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $841.30 / $1,264.16 / $2,513.52	Professional		$841.30	$1,264.16	$2,513.52
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $279.27 / $395.16 / $424.60	Professional	55	$279.27	$395.16	$424.60
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,100.91 / $3,100.91 / $3,100.91	Professional		$3,100.91	$3,100.91	$3,100.91
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $606.65 / $682.48 / $834.14	Professional		$606.65	$682.48	$834.14
United Facility/Professional Facility Modifier Low / Median / High Price $5,307.00 / $12,313.00 / $26,451.00	Facility		$5,307.00	$12,313.00	$26,451.00
United Facility/Professional Professional Modifier Low / Median / High Price $698.51 / $992.72 / $2,252.55	Professional		$698.51	$992.72	$2,252.55