Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.43 / $794.43 / $866.31	Facility		$794.43	$794.43	$866.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $749.00 / $996.84 / $3,453.02	Professional		$749.00	$996.84	$3,453.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $841.65 / $1,991.25 / $1,991.25	Professional		$841.65	$1,991.25	$1,991.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,122.42 / $1,122.42 / $1,271.08	Facility		$1,122.42	$1,122.42	$1,271.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $847.10 / $1,155.24 / $1,990.89	Professional		$847.10	$1,155.24	$1,990.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $664.78 / $976.20 / $2,326.08	Professional		$664.78	$976.20	$2,326.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,020.16 / $1,020.16 / $1,020.16	Facility		$1,020.16	$1,020.16	$1,020.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $865.89 / $1,165.59 / $2,605.01	Professional		$865.89	$1,165.59	$2,605.01
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $299.00 / $973.03 / $1,313.59	Professional		$299.00	$973.03	$1,313.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $804.28 / $1,081.28 / $2,121.21	Professional		$804.28	$1,081.28	$2,121.21
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,947.44 / $3,991.95 / $4,308.96	Facility		$1,947.44	$3,991.95	$4,308.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,114.99 / $8,114.99 / $8,114.99	Professional		$8,114.99	$8,114.99	$8,114.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,280.70	Professional		$32.34	$32.34	$1,280.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $785.67 / $1,072.36 / $1,554.14	Facility		$785.67	$1,072.36	$1,554.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $890.65 / $1,306.68 / $2,407.27	Professional		$890.65	$1,306.68	$2,407.27
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,389.28 / $2,389.28 / $2,389.28	Professional		$2,389.28	$2,389.28	$2,389.28
United Facility/Professional Professional Modifier Low / Median / High Price $714.47 / $957.45 / $2,130.32	Professional		$714.47	$957.45	$2,130.32