Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,696.00 / $10,406.00 / $35,051.19	Facility		$3,696.00	$10,406.00	$35,051.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,361.75 / $1,580.64 / $4,074.76	Professional		$1,361.75	$1,580.64	$4,074.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $997.70 / $1,259.35 / $2,752.67	Professional		$997.70	$1,259.35	$2,752.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $10,905.00 / $21,514.00	Facility		$2,456.00	$10,905.00	$21,514.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,762.84 / $2,176.67 / $4,423.77	Professional		$1,762.84	$2,176.67	$4,423.77
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 $1,023.96 / $1,476.51 / $3,378.85	Professional		$1,023.96	$1,476.51	$3,378.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $3,736.88 / $5,093.59	Facility		$705.31	$3,736.88	$5,093.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,369.78 / $1,857.47 / $3,816.32	Professional		$1,369.78	$1,857.47	$3,816.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.60 / $1,708.01 / $2,221.91	Professional		$1,174.60	$1,708.01	$2,221.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,228.58 / $1,632.24 / $3,078.44	Professional		$1,228.58	$1,632.24	$3,078.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $5,897.00 / $14,907.95	Facility		$5,897.00	$5,897.00	$14,907.95
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $304.29 / $1,413.06 / $1,413.06	Facility	AS	$304.29	$1,413.06	$1,413.06
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,366.67 / $11,366.67 / $11,366.67	Professional		$11,366.67	$11,366.67	$11,366.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,383.25 / $1,805.19 / $2,845.80	Facility		$1,383.25	$1,805.19	$2,845.80
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $493.75 / $493.75 / $493.75	Facility	80	$493.75	$493.75	$493.75
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $419.69 / $419.69 / $419.69	Facility	AS	$419.69	$419.69	$419.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,369.78 / $1,966.06 / $3,816.32	Professional		$1,369.78	$1,966.06	$3,816.32
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $4,375.93 / $4,375.93 / $4,375.93	Professional		$4,375.93	$4,375.93	$4,375.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,254.93 / $1,725.53 / $2,518.16	Professional		$1,254.93	$1,725.53	$2,518.16
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 $1,078.65 / $1,450.94 / $3,330.80	Professional		$1,078.65	$1,450.94	$3,330.80