Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.00 / $6,423.00 / $17,380.00	Facility		$656.00	$6,423.00	$17,380.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,827.12 / $6,441.48 / $12,391.86	Facility	50	$3,827.12	$6,441.48	$12,391.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.22 / $573.34 / $1,829.02	Professional		$446.22	$573.34	$1,829.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $406.75 / $690.34 / $3,364.95	Professional	50	$406.75	$690.34	$3,364.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $322.49 / $322.49 / $827.64	Professional	50	$322.49	$322.49	$827.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,546.00 / $4,617.00 / $9,381.00	Facility		$1,546.00	$4,617.00	$9,381.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $464.35 / $686.55 / $1,346.93	Professional		$464.35	$686.55	$1,346.93
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $804.91 / $946.95 / $1,052.17	Professional	50	$804.91	$946.95	$1,052.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $9,497.06	Facility		$66.00	$100.00	$9,497.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $447.14 / $638.77 / $1,320.12	Professional		$447.14	$638.77	$1,320.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $1,458.73 / $1,988.34	Facility		$705.31	$1,458.73	$1,988.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.74 / $704.68 / $1,369.90	Professional		$487.74	$704.68	$1,369.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $329.86 / $718.26 / $1,073.86	Professional		$329.86	$718.26	$1,073.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $484.00 / $703.47 / $1,304.83	Professional		$484.00	$703.47	$1,304.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,445.08 / $3,537.66 / $26,542.00	Facility		$3,445.08	$3,537.66	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,659.44 / $4,682.96 / $5,376.15	Professional		$3,659.44	$4,682.96	$5,376.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $534.04 / $729.98 / $1,058.93	Facility		$534.04	$729.98	$1,058.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $499.96 / $760.77 / $1,512.39	Professional		$499.96	$760.77	$1,512.39
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,661.14 / $1,661.14 / $2,132.39	Professional		$1,661.14	$1,661.14	$2,132.39
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $428.82 / $582.37 / $748.76	Professional		$428.82	$582.37	$748.76
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,352.00 / $14,743.00	Facility		$3,523.00	$7,352.00	$14,743.00
United Facility/Professional Professional Modifier Low / Median / High Price $494.10 / $640.50 / $1,610.40	Professional		$494.10	$640.50	$1,610.40