Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $646.86 / $2,668.48 / $40,740.00	Facility		$646.86	$2,668.48	$40,740.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $581.22 / $683.81 / $2,753.65	Professional		$581.22	$683.81	$2,753.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $681.69 / $1,083.28 / $1,485.30	Professional		$681.69	$1,083.28	$1,485.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $639.16 / $931.00 / $23,591.00	Facility		$639.16	$931.00	$23,591.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.54 / $897.29 / $1,805.46	Professional		$645.54	$897.29	$1,805.46
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.50 / $100.00 / $2,000.61	Facility		$57.50	$100.00	$2,000.61
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $489.32 / $699.03 / $1,715.85	Professional		$489.32	$699.03	$1,715.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13,137.00 / $38,137.00 / $57,325.00	Facility		$13,137.00	$38,137.00	$57,325.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.40 / $767.26 / $1,722.40	Professional		$539.40	$767.26	$1,722.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $536.14 / $737.13 / $995.13	Professional		$536.14	$737.13	$995.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $601.19 / $779.95 / $1,433.72	Professional		$601.19	$779.95	$1,433.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,757.28 / $5,947.12 / $6,023.52	Facility		$4,757.28	$5,947.12	$6,023.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,981.67 / $11,983.88 / $12,463.23	Professional		$3,981.67	$11,983.88	$12,463.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $618.72 / $827.51 / $1,414.58	Facility		$618.72	$827.51	$1,414.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $541.03 / $786.04 / $1,671.71	Professional		$541.03	$786.04	$1,671.71
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,100.37 / $2,100.37 / $2,100.37	Professional		$2,100.37	$2,100.37	$2,100.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $595.55 / $750.59 / $911.43	Professional		$595.55	$750.59	$911.43
United Facility/Professional Professional Modifier Low / Median / High Price $522.40 / $828.26 / $1,777.22	Professional		$522.40	$828.26	$1,777.22