Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.55 / $2,197.85 / $13,916.00	Facility		$65.55	$2,197.85	$13,916.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $85.28 / $218.92 / $3,163.41	Facility	50	$85.28	$218.92	$3,163.41
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $14.64 / $23.52 / $144.12	Facility	52	$14.64	$23.52	$144.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $60.45 / $195.51	Professional		$29.28	$60.45	$195.51
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $42.57 / $51.28 / $152.86	Professional	22	$42.57	$51.28	$152.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.65 / $127.55 / $293.26	Professional	50	$47.65	$127.55	$293.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.54 / $23.52 / $95.15	Professional	52	$13.54	$23.52	$95.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.57 / $48.90 / $93.58	Professional		$41.57	$48.90	$93.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $62.35 / $77.20 / $123.59	Professional	50	$62.35	$77.20	$123.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,505.00 / $9,119.00	Facility		$1,723.00	$4,505.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $51.25 / $114.69	Professional		$30.59	$51.25	$114.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.47 / $72.04 / $94.58	Professional	50	$52.47	$72.04	$94.58
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $1,588.01	Facility		$64.40	$100.00	$1,588.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $31.07 / $41.88 / $100.00	Professional		$31.07	$41.88	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.82 / $55.07 / $132.61	Professional		$33.82	$55.07	$132.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $38.50 / $63.10	Professional		$30.53	$38.50	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $51.35 / $88.90	Professional		$32.14	$51.35	$88.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $182.35 / $189.20	Facility		$55.00	$182.35	$189.20
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $65.76 / $125.18 / $125.18	Facility	52	$65.76	$125.18	$125.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $233.44 / $348.00 / $400.73	Professional		$233.44	$348.00	$400.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.36 / $51.09 / $80.81	Facility		$33.36	$51.09	$80.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $56.91 / $125.79	Professional		$34.04	$56.91	$125.79
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $107.34 / $155.43	Professional		$107.34	$107.34	$155.43
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $39.22 / $63.72	Professional		$28.52	$39.22	$63.72
United Facility/Professional Facility Modifier Low / Median / High Price $466.00 / $1,506.00 / $6,323.00	Facility		$466.00	$1,506.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.20 / $57.08 / $191.25	Professional		$39.20	$57.08	$191.25