Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,305.00 / $9,006.00 / $23,981.00	Facility		$3,305.00	$9,006.00	$23,981.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $667.51 / $881.74 / $2,074.42	Professional		$667.51	$881.74	$2,074.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $808.53 / $854.70 / $1,549.03	Professional		$808.53	$854.70	$1,549.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,275.00 / $7,109.00 / $14,981.00	Facility		$2,275.00	$7,109.00	$14,981.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $873.04 / $1,420.03 / $2,649.17	Professional		$873.04	$1,420.03	$2,649.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $10,421.18	Facility		$66.00	$100.00	$10,421.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $650.70 / $942.64 / $2,173.80	Professional		$650.70	$942.64	$2,173.80
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 $800.31 / $1,097.70 / $2,514.59	Professional		$800.31	$1,097.70	$2,514.59
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,058.23 / $1,269.88 / $2,183.17	Professional		$1,058.23	$1,269.88	$2,183.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $833.43 / $1,108.34 / $2,128.60	Professional		$833.43	$1,108.34	$2,128.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,663.70 / $11,879.05 / $26,542.00	Facility		$5,663.70	$11,879.05	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $205.59 / $1,125.97 / $1,125.97	Facility	AS	$205.59	$1,125.97	$1,125.97
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,588.48 / $7,588.48 / $7,588.48	Professional		$7,588.48	$7,588.48	$7,588.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $949.67 / $1,207.65 / $2,257.66	Facility		$949.67	$1,207.65	$2,257.66
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $333.15 / $333.15 / $333.15	Facility	80	$333.15	$333.15	$333.15
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $283.18 / $283.18 / $283.18	Facility	AS	$283.18	$283.18	$283.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $816.97 / $1,175.22 / $2,514.59	Professional		$816.97	$1,175.22	$2,514.59
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,947.42 / $2,947.42 / $2,947.42	Professional		$2,947.42	$2,947.42	$2,947.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $930.35 / $1,500.37 / $2,474.27	Professional		$930.35	$1,500.37	$2,474.27
United Facility/Professional Facility Modifier Low / Median / High Price $5,416.00 / $12,267.00 / $26,109.00	Facility		$5,416.00	$12,267.00	$26,109.00
United Facility/Professional Professional Modifier Low / Median / High Price $712.32 / $915.84 / $2,173.17	Professional		$712.32	$915.84	$2,173.17