Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $517.89 / $4,949.97 / $13,783.30	Facility		$517.89	$4,949.97	$13,783.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.89 / $1,286.16 / $13,783.30	Professional		$517.89	$1,286.16	$13,783.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $715.96 / $715.96 / $857.44	Professional		$715.96	$715.96	$857.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.00 / $3,703.93 / $10,567.95	Facility		$614.00	$3,703.93	$10,567.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $857.44 / $883.16 / $3,086.78	Professional		$857.44	$883.16	$3,086.78
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $1,549.82 / $6,044.95	Facility		$92.60	$1,549.82	$6,044.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $975.34 / $1,393.34 / $3,484.05	Professional		$975.34	$1,393.34	$3,484.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,393.34 / $3,017.97 / $7,015.47	Facility		$1,393.34	$3,017.97	$7,015.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.50 / $1,420.25 / $3,810.43	Professional		$812.50	$1,420.25	$3,810.43
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,143.60 / $2,357.96 / $3,429.76	Professional		$2,143.60	$2,357.96	$3,429.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,714.88 / $2,357.96 / $3,751.30	Professional		$1,714.88	$2,357.96	$3,751.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,429.76 / $10,182.10 / $10,182.10	Facility		$3,429.76	$10,182.10	$10,182.10
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,718.00 / $10,718.00 / $16,077.00	Professional		$10,718.00	$10,718.00	$16,077.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,071.80 / $1,071.80 / $1,500.52	Professional		$1,071.80	$1,071.80	$1,500.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,286.16 / $2,143.60 / $4,783.47	Facility		$1,286.16	$2,143.60	$4,783.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $572.00 / $2,143.60 / $4,036.84	Professional		$572.00	$2,143.60	$4,036.84
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $7,524.03 / $7,524.03 / $7,524.03	Professional		$7,524.03	$7,524.03	$7,524.03
United Facility/Professional Professional Modifier Low / Median / High Price $252.88 / $900.31 / $4,302.21	Professional		$252.88	$900.31	$4,302.21