Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $289.00 / $5,980.00 / $17,054.00	Facility		$289.00	$5,980.00	$17,054.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,384.26 / $1,667.09 / $1,667.09	Facility	50	$1,384.26	$1,667.09	$1,667.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.85 / $208.78 / $895.00	Professional		$123.85	$208.78	$895.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $290.77 / $351.71 / $1,486.50	Professional	50	$290.77	$351.71	$1,486.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,759.00 / $4,505.00 / $9,119.00	Facility		$1,759.00	$4,505.00	$9,119.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.47 / $204.05 / $485.94	Professional		$122.47	$204.05	$485.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $211.41 / $297.05 / $400.21	Professional	50	$211.41	$297.05	$400.21
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,117.38	Facility		$66.00	$100.00	$5,117.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $134.50 / $194.78 / $435.09	Professional		$134.50	$194.78	$435.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.67 / $205.24 / $483.53	Facility		$173.67	$205.24	$483.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $223.41 / $549.48	Professional		$137.93	$223.41	$549.48
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $59.94 / $177.36 / $278.83	Professional		$59.94	$177.36	$278.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.26 / $221.84 / $388.45	Professional		$140.26	$221.84	$388.45
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $610.08 / $685.62	Facility		$55.00	$610.08	$685.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,027.00 / $1,447.92 / $1,696.20	Professional		$1,027.00	$1,447.92	$1,696.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $148.35 / $215.47 / $329.18	Facility		$148.35	$215.47	$329.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.41 / $236.84 / $542.38	Professional		$139.41	$236.84	$542.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $427.10 / $427.10 / $655.51	Professional		$427.10	$427.10	$655.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $130.26 / $281.73	Professional		$75.59	$130.26	$281.73
United Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $1,506.00 / $6,920.00	Facility		$510.00	$1,506.00	$6,920.00
United Facility/Professional Professional Modifier Low / Median / High Price $157.96 / $223.78 / $686.38	Professional		$157.96	$223.78	$686.38