Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,584.89 / $3,715.35	Professional		$645.65	$1,584.89	$3,715.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,047.13 / $4,897.79	Facility		$831.76	$1,047.13	$4,897.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,737.80	Professional		$794.33	$1,000.00	$1,737.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,122.02 / $2,238.72	Professional		$776.25	$1,122.02	$2,238.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,023.29 / $1,949.84	Professional		$758.58	$1,023.29	$1,949.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $758.58 / $977.24	Professional		$302.00	$758.58	$977.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $758.58 / $1,995.26	Professional		$616.60	$758.58	$1,995.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $4,897.79 / $4,897.79	Facility		$4,897.79	$4,897.79	$4,897.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,079.46 / $7,079.46 / $7,079.46	Professional		$7,079.46	$7,079.46	$7,079.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $891.25 / $1,548.82	Facility		$660.69	$891.25	$1,548.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,047.13 / $1,995.26	Professional		$758.58	$1,047.13	$1,995.26
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Professional		$2,089.30	$2,089.30	$2,089.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $602.56 / $831.76	Professional		$302.00	$602.56	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $831.76 / $1,584.89	Professional		$616.60	$831.76	$1,584.89