Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,706.00 / $10,209.00 / $24,401.00	Facility		$3,706.00	$10,209.00	$24,401.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,181.34 / $1,304.46 / $4,213.64	Professional		$1,181.34	$1,304.46	$4,213.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $912.54 / $1,030.69 / $1,288.30	Professional		$912.54	$1,030.69	$1,288.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $8,592.00 / $17,774.00	Facility		$2,456.00	$8,592.00	$17,774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,538.40 / $2,016.36 / $3,876.79	Professional		$1,538.40	$2,016.36	$3,876.79
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 $902.39 / $1,310.42 / $3,030.03	Professional		$902.39	$1,310.42	$3,030.03
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 $1,098.64 / $1,585.34 / $3,252.61	Professional		$1,098.64	$1,585.34	$3,252.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $941.17 / $1,411.76 / $1,803.11	Professional		$941.17	$1,411.76	$1,803.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,056.77 / $1,404.01 / $2,696.42	Professional		$1,056.77	$1,404.01	$2,696.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,150.00 / $2,150.00 / $11,879.05	Facility		$2,150.00	$2,150.00	$11,879.05
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $261.70 / $1,125.97 / $1,125.97	Facility	AS	$261.70	$1,125.97	$1,125.97
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,185.05 / $11,185.05 / $11,185.05	Professional		$11,185.05	$11,185.05	$11,185.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,189.83 / $1,554.15 / $2,475.01	Facility		$1,189.83	$1,554.15	$2,475.01
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 Facility Modifier AS Low / Median / High Price $360.71 / $360.71 / $360.71	Facility	AS	$360.71	$360.71	$360.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,144.30 / $1,664.61 / $3,197.11	Professional		$1,144.30	$1,664.61	$3,197.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,760.89 / $3,760.89 / $3,760.89	Professional		$3,760.89	$3,760.89	$3,760.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,079.46 / $1,411.76 / $2,017.72	Professional		$1,079.46	$1,411.76	$2,017.72
United Facility/Professional Facility Modifier Low / Median / High Price $5,478.00 / $12,150.00 / $26,109.00	Facility		$5,478.00	$12,150.00	$26,109.00
United Facility/Professional Professional Modifier Low / Median / High Price $910.84 / $1,271.76 / $2,769.48	Professional		$910.84	$1,271.76	$2,769.48