Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,040.00 / $13,782.00 / $58,116.04	Facility		$4,040.00	$13,782.00	$58,116.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $193.33 / $211.01 / $1,253.81	Facility	53	$193.33	$211.01	$1,253.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $924.90 / $1,102.35 / $4,618.05	Professional		$924.90	$1,102.35	$4,618.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $878.66 / $878.66 / $1,794.96	Professional		$878.66	$878.66	$1,794.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,294.00 / $15,064.00 / $32,242.00	Facility		$4,294.00	$15,064.00	$32,242.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,447.26 / $2,068.64 / $3,770.15	Professional		$1,447.26	$2,068.64	$3,770.15
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $25,389.86	Facility		$67.90	$100.00	$25,389.86
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $748.73 / $1,110.36 / $2,474.13	Professional		$748.73	$1,110.36	$2,474.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,030.00 / $21,660.00 / $31,488.00	Facility		$11,030.00	$21,660.00	$31,488.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,078.83 / $1,356.25 / $3,513.03	Professional		$1,078.83	$1,356.25	$3,513.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $880.47 / $970.29 / $1,309.89	Professional		$880.47	$970.29	$1,309.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.90 / $1,088.63 / $2,044.09	Professional		$870.90	$1,088.63	$2,044.09
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,427.54 / $26,727.00 / $26,727.00	Facility		$9,427.54	$26,727.00	$26,727.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $271.63 / $5,345.40 / $5,345.40	Facility	53	$271.63	$5,345.40	$5,345.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,806.64 / $6,806.64 / $7,877.55	Professional		$6,806.64	$6,806.64	$7,877.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $938.80 / $1,220.44 / $22,084.00	Facility		$938.80	$1,220.44	$22,084.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,070.72 / $1,343.22 / $3,176.21	Professional		$1,070.72	$1,343.22	$3,176.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,578.96 / $3,578.96 / $3,578.96	Professional		$3,578.96	$3,578.96	$3,578.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $880.47 / $1,116.69 / $1,675.03	Professional		$880.47	$1,116.69	$1,675.03
United Facility/Professional Facility Modifier Low / Median / High Price $9,423.00 / $19,072.00 / $51,639.00	Facility		$9,423.00	$19,072.00	$51,639.00
United Facility/Professional Professional Modifier Low / Median / High Price $945.98 / $1,377.39 / $3,227.46	Professional		$945.98	$1,377.39	$3,227.46