Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $697.00 / $6,695.00 / $17,538.00	Facility		$697.00	$6,695.00	$17,538.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,093.48 / $7,943.23 / $18,553.90	Facility	50	$6,093.48	$7,943.23	$18,553.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $376.89 / $519.79 / $2,076.27	Professional		$376.89	$519.79	$2,076.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.04 / $780.44 / $3,630.00	Professional	50	$78.04	$780.44	$3,630.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.52 / $224.52 / $489.86	Professional		$224.52	$224.52	$489.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,115.54 / $1,115.54 / $1,115.54	Professional	50	$1,115.54	$1,115.54	$1,115.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,275.00 / $8,441.00 / $16,676.00	Facility		$2,275.00	$8,441.00	$16,676.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $397.61 / $637.40 / $1,230.55	Professional		$397.61	$637.40	$1,230.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $620.44 / $732.19 / $933.00	Professional	50	$620.44	$732.19	$933.00
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 $345.41 / $493.44 / $1,168.18	Professional		$345.41	$493.44	$1,168.18
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 $416.57 / $571.65 / $1,144.20	Professional		$416.57	$571.65	$1,144.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $433.36 / $655.80 / $900.06	Professional		$433.36	$655.80	$900.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $417.39 / $600.04 / $1,126.00	Professional		$417.39	$600.04	$1,126.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,946.96 / $3,033.24 / $26,542.00	Facility		$2,946.96	$3,033.24	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,606.00 / $5,606.00 / $5,606.00	Professional		$5,606.00	$5,606.00	$5,606.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $520.66 / $688.22 / $1,005.00	Facility		$520.66	$688.22	$1,005.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $420.32 / $614.44 / $1,247.86	Professional		$420.32	$614.44	$1,247.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,406.43 / $1,406.43 / $1,708.17	Professional		$1,406.43	$1,406.43	$1,708.17
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $454.11 / $606.40 / $819.75	Professional		$454.11	$606.40	$819.75
United Facility/Professional Facility Modifier Low / Median / High Price $3,523.00 / $7,359.00 / $15,471.00	Facility		$3,523.00	$7,359.00	$15,471.00
United Facility/Professional Professional Modifier Low / Median / High Price $398.77 / $511.70 / $1,296.59	Professional		$398.77	$511.70	$1,296.59