Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,399.50 / $11,711.00 / $35,870.91	Facility		$4,399.50	$11,711.00	$35,870.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,255.67 / $1,450.00 / $3,830.86	Professional		$1,255.67	$1,450.00	$3,830.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,012.55 / $1,134.22 / $1,570.59	Professional		$1,012.55	$1,134.22	$1,570.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $9,624.00 / $19,574.00	Facility		$2,456.00	$9,624.00	$19,574.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,632.80 / $2,282.76 / $4,114.68	Professional		$1,632.80	$2,282.76	$4,114.68
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $15,290.89	Facility		$66.00	$100.00	$15,290.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,089.45 / $1,579.60 / $3,576.80	Professional		$1,089.45	$1,579.60	$3,576.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,115.57 / $2,977.65 / $4,058.71	Facility		$1,115.57	$2,977.65	$4,058.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,257.20 / $1,759.88 / $3,384.69	Professional		$1,257.20	$1,759.88	$3,384.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,052.11 / $1,527.69 / $1,990.22	Professional		$1,052.11	$1,527.69	$1,990.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,099.66 / $1,460.78 / $2,805.44	Professional		$1,099.66	$1,460.78	$2,805.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $7,513.80 / $11,879.05 / $26,542.00	Facility		$7,513.80	$11,879.05	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $272.45 / $1,125.97 / $1,125.97	Facility	AS	$272.45	$1,125.97	$1,125.97
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,464.70 / $10,464.70 / $10,464.70	Professional		$10,464.70	$10,464.70	$10,464.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,303.67 / $1,858.40 / $2,996.00	Facility		$1,303.67	$1,858.40	$2,996.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $441.71 / $441.71 / $441.71	Facility	80	$441.71	$441.71	$441.71
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $375.46 / $375.46 / $375.46	Facility	AS	$375.46	$375.46	$375.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,264.25 / $1,805.03 / $3,412.66	Professional		$1,264.25	$1,805.03	$3,412.66
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,915.75 / $3,915.75 / $3,915.75	Professional		$3,915.75	$3,915.75	$3,915.75
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,122.41 / $1,543.31 / $2,255.57	Professional		$1,122.41	$1,543.31	$2,255.57
United Facility/Professional Facility Modifier Low / Median / High Price $5,307.00 / $12,313.00 / $26,451.00	Facility		$5,307.00	$12,313.00	$26,451.00
United Facility/Professional Professional Modifier Low / Median / High Price $977.88 / $1,337.23 / $3,131.99	Professional		$977.88	$1,337.23	$3,131.99