Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $10,715.19 / $23,988.33	Facility		$4,897.79	$10,715.19	$23,988.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,318.26 / $3,311.31	Professional		$1,122.02	$1,318.26	$3,311.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $977.24 / $1,202.26	Professional		$977.24	$977.24	$1,202.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,025.60 / $10,471.29 / $17,782.79	Facility		$6,025.60	$10,471.29	$17,782.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $2,238.72 / $3,981.07	Professional		$1,348.96	$2,238.72	$3,981.07
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $5,623.41 / $16,982.44	Facility		$66.07	$5,623.41	$16,982.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,659.59 / $3,715.35	Professional		$1,230.27	$1,659.59	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,659.59 / $4,073.80	Facility		$1,122.02	$1,659.59	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $2,818.38	Professional		$1,047.13	$1,513.56	$2,818.38
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,148.15 / $1,737.80	Professional		$912.01	$1,148.15	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,071.52 / $2,137.96	Professional		$831.76	$1,071.52	$2,137.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,748.98 / $33,884.42 / $33,884.42	Facility		$11,748.98	$33,884.42	$33,884.42
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility	AS	$1,174.90	$1,174.90	$1,174.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,912.51 / $8,912.51 / $8,912.51	Professional		$8,912.51	$8,912.51	$8,912.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Professional		$1,445.44	$1,445.44	$1,445.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $2,630.27	Facility		$1,047.13	$1,513.56	$2,630.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $2,818.38	Professional		$1,096.48	$1,513.56	$2,818.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,288.25 / $1,949.84	Professional		$912.01	$1,288.25	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $6,309.57 / $12,022.64 / $25,703.96	Facility		$6,309.57	$12,022.64	$25,703.96
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,174.90 / $2,570.40	Professional		$851.14	$1,174.90	$2,570.40