Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,546.09 / $9,690.00 / $22,788.00	Facility		$3,546.09	$9,690.00	$22,788.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $586.99 / $634.99 / $4,151.30	Facility	54	$586.99	$634.99	$4,151.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $711.73 / $866.44 / $2,175.76	Professional		$711.73	$866.44	$2,175.76
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $105.42 / $136.16 / $718.19	Professional	55	$105.42	$136.16	$718.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $816.93 / $816.93 / $833.27	Professional		$816.93	$816.93	$833.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,415.00 / $9,126.00 / $18,526.00	Facility		$2,415.00	$9,126.00	$18,526.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $896.75 / $1,257.04 / $2,392.91	Professional		$896.75	$1,257.04	$2,392.91
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $12,704.07	Facility		$66.00	$100.00	$12,704.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $663.80 / $961.77 / $2,218.69	Professional		$663.80	$961.77	$2,218.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $907.04 / $1,726.46 / $2,353.27	Facility		$907.04	$1,726.46	$2,353.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.34 / $1,067.58 / $2,446.23	Professional		$794.34	$1,067.58	$2,446.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $505.96 / $1,065.56 / $1,438.51	Professional		$505.96	$1,065.56	$1,438.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $839.37 / $1,116.19 / $2,104.01	Professional		$839.37	$1,116.19	$2,104.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,074.35 / $11,500.00 / $26,542.00	Facility		$4,074.35	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,449.79 / $4,569.92 / $4,569.92	Facility	54	$1,449.79	$4,569.92	$4,569.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,516.24 / $6,715.76 / $7,369.65	Professional		$6,516.24	$6,715.76	$7,369.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $956.37 / $1,210.71 / $1,941.69	Facility		$956.37	$1,210.71	$1,941.69
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,679.23 / $1,679.23 / $1,679.23	Facility	54	$1,679.23	$1,679.23	$1,679.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $794.34 / $1,150.22 / $2,483.30	Professional		$794.34	$1,150.22	$2,483.30
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $331.98 / $413.53 / $496.66	Professional	55	$331.98	$413.53	$496.66
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,970.81 / $2,970.81 / $2,970.81	Professional		$2,970.81	$2,970.81	$2,970.81
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $638.04 / $893.27 / $1,184.22	Professional		$638.04	$893.27	$1,184.22
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 $694.71 / $901.32 / $2,190.28	Professional		$694.71	$901.32	$2,190.28