Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $2,070.00 / $13,782.00	Facility		$106.00	$2,070.00	$13,782.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $22.74 / $69.00	Professional		$11.54	$22.74	$69.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $23.98 / $43.58 / $109.29	Professional	50	$23.98	$43.58	$109.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $5.73 / $7.20 / $48.33	Professional	52	$5.73	$7.20	$48.33
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.29 / $4.58 / $19.32	Professional	53	$2.29	$4.58	$19.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.90 / $17.09 / $37.24	Professional		$14.90	$17.09	$37.24
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $21.14 / $43.52 / $61.25	Professional	50	$21.14	$43.52	$61.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.29 / $25.57 / $4,604.00	Facility		$20.29	$25.57	$4,604.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $26.42 / $51.58	Professional		$20.47	$26.42	$51.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $20.37 / $24.50 / $31.34	Professional	50	$20.37	$24.50	$31.34
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $100.00 / $1,588.01	Facility		$65.80	$100.00	$1,588.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $11.93 / $15.96 / $43.30	Professional		$11.93	$15.96	$43.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.37 / $20.10 / $53.75	Professional		$13.37	$20.10	$53.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $11.08 / $14.55 / $25.51	Professional		$11.08	$14.55	$25.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $22.34 / $39.97	Professional		$16.55	$22.34	$39.97
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $55.00 / $85.45	Facility		$50.00	$55.00	$85.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $111.04 / $116.72 / $134.18	Professional		$111.04	$116.72	$134.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.19 / $21.59 / $31.20	Facility		$16.19	$21.59	$31.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $13.55 / $20.75 / $44.26	Professional		$13.55	$20.75	$44.26
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $47.53 / $47.53	Professional		$47.53	$47.53	$47.53
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $16.62 / $23.64	Professional		$11.54	$16.62	$23.64
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,551.00 / $6,920.00	Facility		$548.00	$1,551.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $11.20 / $16.46 / $46.52	Professional		$11.20	$16.46	$46.52