Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,546.09 / $10,230.00 / $23,990.88	Facility		$3,546.09	$10,230.00	$23,990.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,072.81 / $1,216.64 / $2,773.20	Professional		$1,072.81	$1,216.64	$2,773.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $962.92 / $1,030.69 / $1,288.30	Professional		$962.92	$1,030.69	$1,288.30
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 $1,344.59 / $1,773.72 / $3,396.72	Professional		$1,344.59	$1,773.72	$3,396.72
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $8,938.65	Facility		$66.00	$100.00	$8,938.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $790.13 / $1,146.95 / $2,650.60	Professional		$790.13	$1,146.95	$2,650.60
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 $1,037.83 / $1,455.49 / $3,197.11	Professional		$1,037.83	$1,455.49	$3,197.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $823.16 / $1,335.64 / $1,803.11	Professional		$823.16	$1,335.64	$1,803.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,056.77 / $1,404.01 / $2,700.64	Professional		$1,056.77	$1,404.01	$2,700.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $7,213.99 / $11,879.05	Facility		$55.00	$7,213.99	$11,879.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,602.35 / $9,602.35 / $9,602.35	Professional		$9,602.35	$9,602.35	$9,602.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,180.94 / $1,519.04 / $2,284.00	Facility		$1,180.94	$1,519.04	$2,284.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $424.37 / $424.37 / $424.37	Facility	80	$424.37	$424.37	$424.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,076.18 / $1,537.17 / $3,192.13	Professional		$1,076.18	$1,537.17	$3,192.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,762.10 / $3,762.10 / $3,762.10	Professional		$3,762.10	$3,762.10	$3,762.10
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,038.06 / $1,234.73 / $1,764.71	Professional		$1,038.06	$1,234.73	$1,764.71
United Facility/Professional Facility Modifier Low / Median / High Price $5,416.00 / $12,341.00 / $26,451.00	Facility		$5,416.00	$12,341.00	$26,451.00
United Facility/Professional Professional Modifier Low / Median / High Price $911.13 / $1,183.34 / $2,922.45	Professional		$911.13	$1,183.34	$2,922.45