Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.18 / $4,749.00 / $16,109.00	Facility		$198.18	$4,749.00	$16,109.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,752.00 / $2,752.00 / $2,956.00	Facility	50	$2,752.00	$2,752.00	$2,956.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.15 / $179.19 / $510.54	Professional		$128.15	$179.19	$510.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $194.52 / $273.29 / $1,038.50	Professional	50	$194.52	$273.29	$1,038.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.14 / $192.14 / $192.14	Professional		$192.14	$192.14	$192.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,546.00 / $4,465.00 / $8,976.00	Facility		$1,546.00	$4,465.00	$8,976.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.00 / $202.27 / $418.22	Professional		$135.00	$202.27	$418.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $284.86 / $306.12 / $378.64	Professional	50	$284.86	$306.12	$378.64
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,021.77	Facility		$66.00	$100.00	$5,021.77
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $137.66 / $208.91 / $414.32	Professional		$137.66	$208.91	$414.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $207.88 / $277.08 / $283.35	Facility		$207.88	$277.08	$283.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.16 / $224.69 / $501.45	Professional		$143.16	$224.69	$501.45
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $137.38 / $207.90 / $326.72	Professional		$137.38	$207.90	$326.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.97 / $232.84 / $416.34	Professional		$148.97	$232.84	$416.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,000.92 / $1,025.88	Facility		$55.00	$1,000.92	$1,025.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,061.59 / $1,798.73 / $1,917.67	Professional		$1,061.59	$1,798.73	$1,917.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $132.84 / $220.90 / $351.59	Facility		$132.84	$220.90	$351.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.31 / $247.22 / $517.36	Professional		$147.31	$247.22	$517.36
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $477.93 / $477.93 / $713.55	Professional		$477.93	$477.93	$713.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $142.87 / $196.49 / $294.52	Professional		$142.87	$196.49	$294.52
United Facility/Professional Facility Modifier Low / Median / High Price $466.00 / $1,493.00 / $5,830.00	Facility		$466.00	$1,493.00	$5,830.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.89 / $208.01 / $485.95	Professional		$163.89	$208.01	$485.95