Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $663.80 / $663.80 / $3,483.15	Facility		$663.80	$663.80	$3,483.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.59 / $663.80 / $962.50	Professional		$575.59	$663.80	$962.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $905.43 / $965.79 / $965.79	Professional		$905.43	$965.79	$965.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $504.08 / $1,832.08 / $3,832.14	Facility		$504.08	$1,832.08	$3,832.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $603.39 / $661.43 / $1,150.28	Professional		$603.39	$661.43	$1,150.28
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,429.26 / $2,552.25	Facility		$97.00	$1,429.26	$2,552.25
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,601.80 / $3,731.12	Professional		$100.00	$1,601.80	$3,731.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.07 / $756.07 / $959.04	Facility		$756.07	$756.07	$959.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $551.92 / $551.92 / $806.01	Professional		$551.92	$551.92	$806.01
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $645.30 / $774.37 / $1,327.96	Professional		$645.30	$774.37	$1,327.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.34 / $845.07 / $1,835.00	Professional		$724.34	$845.07	$1,835.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,943.12 / $5,761.13 / $5,761.13	Facility		$1,943.12	$5,761.13	$5,761.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,239.69 / $6,239.69 / $9,054.29	Professional		$6,239.69	$6,239.69	$9,054.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,734.15 / $3,734.15 / $3,734.15	Professional		$3,734.15	$3,734.15	$3,734.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $355.96 / $1,086.52 / $1,243.50	Facility		$355.96	$1,086.52	$1,243.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $551.92 / $756.07 / $1,149.07	Professional		$551.92	$756.07	$1,149.07
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,278.60 / $2,278.60 / $2,278.60	Professional		$2,278.60	$2,278.60	$2,278.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $645.30 / $965.79 / $967.97	Professional		$645.30	$965.79	$967.97
United Facility/Professional Professional Modifier Low / Median / High Price $500.65 / $552.28 / $1,230.84	Professional		$500.65	$552.28	$1,230.84