Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,932.00 / $4,880.68	Facility		$500.00	$1,932.00	$4,880.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $569.29 / $786.45	Professional		$500.00	$569.29	$786.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.52 / $455.43 / $474.41	Professional		$253.52	$455.43	$474.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $1,311.56 / $3,742.12	Facility		$614.00	$1,311.56	$3,742.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $507.33 / $1,100.61	Professional		$400.00	$507.33	$1,100.61
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $548.79 / $2,140.52	Facility		$92.60	$548.79	$2,140.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $385.00 / $550.00 / $1,364.00	Professional		$385.00	$550.00	$1,364.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.40 / $986.76 / $2,447.16	Facility		$530.40	$986.76	$2,447.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.93 / $631.63 / $1,466.02	Professional		$432.93	$631.63	$1,466.02
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $232.00 / $759.05 / $1,024.72	Professional		$232.00	$759.05	$1,024.72
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Professional		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $607.24 / $834.96 / $1,328.34	Professional		$607.24	$834.96	$1,328.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,214.48 / $3,605.49 / $3,605.49	Facility		$1,214.48	$3,605.49	$3,605.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,795.25 / $3,795.25 / $5,692.88	Professional		$3,795.25	$3,795.25	$5,692.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $379.52 / $379.52 / $531.33	Professional		$379.52	$379.52	$531.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $552.82 / $769.67 / $1,812.90	Facility		$552.82	$769.67	$1,812.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $445.87 / $834.96 / $1,466.02	Professional		$445.87	$834.96	$1,466.02
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,664.26 / $2,664.26 / $2,664.26	Professional		$2,664.26	$2,664.26	$2,664.26
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $236.64 / $607.24 / $759.05	Professional		$236.64	$607.24	$759.05
United Facility/Professional Professional Modifier Low / Median / High Price $318.80 / $345.37 / $1,687.37	Professional		$318.80	$345.37	$1,687.37