Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,530.35 / $7,841.00 / $17,828.00	Facility		$3,530.35	$7,841.00	$17,828.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $13,907.00 / $13,907.00 / $16,606.50	Facility	50	$13,907.00	$13,907.00	$16,606.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $131.72 / $141.65 / $667.87	Facility	53	$131.72	$141.65	$667.87
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $493.96 / $531.16 / $2,504.51	Facility	54	$493.96	$531.16	$2,504.51
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $98.79 / $106.23 / $500.90	Facility	55	$98.79	$106.23	$500.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $431.31 / $663.56 / $2,539.92	Professional		$431.31	$663.56	$2,539.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $3,992.71 / $4,329.68 / $4,329.68	Professional	50	$3,992.71	$4,329.68	$4,329.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $276.39 / $329.31 / $1,443.23	Professional	52	$276.39	$329.31	$1,443.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $391.26 / $498.59 / $1,235.53	Professional	54	$391.26	$498.59	$1,235.53
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $60.70 / $98.79 / $399.27	Professional	55	$60.70	$98.79	$399.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $433.40 / $491.18 / $926.06	Professional		$433.40	$491.18	$926.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $10,275.00 / $21,136.00	Facility		$2,456.00	$10,275.00	$21,136.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $742.69 / $1,094.88 / $1,961.09	Professional		$742.69	$1,094.88	$1,961.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $807.79 / $974.02 / $1,477.30	Professional	50	$807.79	$974.02	$1,477.30
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $14,458.60	Facility		$66.70	$100.00	$14,458.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $544.29 / $788.23 / $1,786.30	Professional		$544.29	$788.23	$1,786.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,071.60 / $1,625.00 / $2,353.27	Facility		$1,071.60	$1,625.00	$2,353.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.04 / $810.44 / $1,735.61	Professional		$575.04	$810.44	$1,735.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $644.34 / $1,005.21 / $1,702.52	Professional		$644.34	$1,005.21	$1,702.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $507.18 / $674.54 / $1,271.29	Professional		$507.18	$674.54	$1,271.29
Kaiser Permanente Facility/Professional Professional Modifier 50 Low / Median / High Price $2,970.00 / $2,970.00 / $2,970.00	Professional	50	$2,970.00	$2,970.00	$2,970.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,498.41 / $11,500.00 / $26,542.00	Facility		$2,498.41	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $250.20 / $1,305.69 / $1,305.69	Facility	53	$250.20	$1,305.69	$1,305.69
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $875.69 / $4,569.92 / $4,569.92	Facility	54	$875.69	$4,569.92	$4,569.92
Lucent Health Facility/Professional Facility Modifier 55 Low / Median / High Price $187.65 / $979.27 / $979.27	Facility	55	$187.65	$979.27	$979.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,762.00 / $6,076.05 / $6,276.56	Professional		$5,762.00	$6,076.05	$6,276.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $650.41 / $885.37 / $1,630.79	Facility		$650.41	$885.37	$1,630.79
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,011.14 / $1,011.14 / $1,011.14	Facility	54	$1,011.14	$1,011.14	$1,011.14
Providence Facility/Professional Facility Modifier 55 Low / Median / High Price $252.78 / $252.78 / $252.78	Facility	55	$252.78	$252.78	$252.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $589.98 / $847.23 / $1,723.60	Professional		$589.98	$847.23	$1,723.60
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $799.59 / $996.02 / $1,196.24	Professional	54	$799.59	$996.02	$1,196.24
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $199.90 / $249.01 / $299.06	Professional	55	$199.90	$249.01	$299.06
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $4,027.00 / $4,027.00 / $4,027.00	Facility		$4,027.00	$4,027.00	$4,027.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,791.00 / $1,791.00 / $1,791.00	Professional		$1,791.00	$1,791.00	$1,791.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $566.16 / $1,306.77 / $2,155.01	Professional		$566.16	$1,306.77	$2,155.01
United Facility/Professional Facility Modifier Low / Median / High Price $3,701.06 / $7,042.00 / $14,636.00	Facility		$3,701.06	$7,042.00	$14,636.00
United Facility/Professional Professional Modifier Low / Median / High Price $433.49 / $630.07 / $1,486.22	Professional		$433.49	$630.07	$1,486.22