Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $642.95 / $642.95 / $3,374.57	Facility		$642.95	$642.95	$3,374.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $557.50 / $642.95 / $942.69	Professional		$557.50	$642.95	$942.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $760.24 / $760.24 / $760.24	Professional		$760.24	$760.24	$760.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $488.24 / $1,774.51 / $3,712.66	Facility		$488.24	$1,774.51	$3,712.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $584.58 / $643.89 / $1,114.46	Professional		$584.58	$643.89	$1,114.46
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,384.72 / $2,472.71	Facility		$97.00	$1,384.72	$2,472.71
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,551.87 / $3,614.82	Professional		$100.00	$1,551.87	$3,614.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $280.66 / $736.69 / $929.15	Facility		$280.66	$736.69	$929.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.78 / $537.78 / $1,389.38	Professional		$537.78	$537.78	$1,389.38
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $625.21 / $750.25 / $1,286.56	Professional		$625.21	$750.25	$1,286.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $701.76 / $818.72 / $1,777.79	Professional		$701.76	$818.72	$1,777.79
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,882.53 / $5,580.24 / $5,580.24	Facility		$1,882.53	$5,580.24	$5,580.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,033.17 / $6,033.17 / $8,772.00	Professional		$6,033.17	$6,033.17	$8,772.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,617.61 / $3,617.61 / $3,617.61	Professional		$3,617.61	$3,617.61	$3,617.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $344.78 / $1,015.96 / $1,204.70	Facility		$344.78	$1,015.96	$1,204.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $537.78 / $537.78 / $1,142.19	Professional		$537.78	$537.78	$1,142.19
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,207.57 / $2,207.57 / $2,207.57	Professional		$2,207.57	$2,207.57	$2,207.57
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $625.21 / $935.68 / $937.82	Professional		$625.21	$935.68	$937.82
United Facility/Professional Professional Modifier Low / Median / High Price $484.93 / $534.05 / $1,110.01	Professional		$484.93	$534.05	$1,110.01