Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,387.00 / $8,050.00 / $17,809.00	Facility		$2,387.00	$8,050.00	$17,809.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $492.20 / $537.41 / $3,726.59	Facility	54	$492.20	$537.41	$3,726.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $586.35 / $721.88 / $1,662.73	Professional		$586.35	$721.88	$1,662.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $401.36 / $401.36 / $740.57	Professional		$401.36	$401.36	$740.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,275.00 / $8,441.00 / $16,676.00	Facility		$2,275.00	$8,441.00	$16,676.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.37 / $988.66 / $1,926.84	Professional		$691.37	$988.66	$1,926.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $9,724.66	Facility		$66.00	$100.00	$9,724.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $539.48 / $779.17 / $1,789.48	Professional		$539.48	$779.17	$1,789.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $1,726.46 / $2,353.27	Facility		$705.31	$1,726.46	$2,353.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $678.84 / $927.13 / $2,137.44	Professional		$678.84	$927.13	$2,137.44
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $508.93 / $1,007.54 / $1,360.18	Professional		$508.93	$1,007.54	$1,360.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $781.53 / $1,040.43 / $1,938.35	Professional		$781.53	$1,040.43	$1,938.35
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,737.80 / $11,500.00 / $26,542.00	Facility		$3,737.80	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,331.47 / $4,569.92 / $4,569.92	Facility	54	$1,331.47	$4,569.92	$4,569.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,956.48 / $6,198.56 / $6,805.28	Professional		$5,956.48	$6,198.56	$6,805.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $850.79 / $1,068.35 / $1,471.64	Facility		$850.79	$1,068.35	$1,471.64
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,574.52 / $1,574.52 / $1,574.52	Facility	54	$1,574.52	$1,574.52	$1,574.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $701.26 / $1,012.49 / $2,208.02	Professional		$701.26	$1,012.49	$2,208.02
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,622.88 / $2,622.88 / $2,622.88	Professional		$2,622.88	$2,622.88	$2,622.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $641.80 / $872.98 / $1,119.95	Professional		$641.80	$872.98	$1,119.95
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,352.00 / $14,743.00	Facility		$3,523.00	$7,352.00	$14,743.00
United Facility/Professional Professional Modifier Low / Median / High Price $606.03 / $771.08 / $1,740.74	Professional		$606.03	$771.08	$1,740.74