Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $617.22 / $617.22 / $3,953.44	Facility		$617.22	$617.22	$3,953.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $535.21 / $617.22 / $1,605.73	Professional		$535.21	$617.22	$1,605.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $688.54 / $931.76	Professional		$616.60	$688.54	$931.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $468.71 / $1,930.93 / $4,349.52	Facility		$468.71	$1,930.93	$4,349.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $550.77 / $613.00 / $1,049.95	Professional		$550.77	$613.00	$1,049.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,622.22 / $2,896.82	Facility		$97.00	$1,622.22	$2,896.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,818.05 / $4,234.84	Professional		$100.00	$1,818.05	$4,234.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $640.45 / $700.00 / $773.33	Facility		$640.45	$700.00	$773.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $511.00 / $773.33	Professional		$511.00	$511.00	$773.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $654.94 / $785.93 / $1,507.25	Professional		$654.94	$785.93	$1,507.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $822.14 / $959.16 / $2,082.75	Professional		$822.14	$959.16	$2,082.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,205.96 / $6,508.59 / $6,508.59	Facility		$2,205.96	$6,508.59	$6,508.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,973.74 / $7,141.10 / $10,276.73	Professional		$6,973.74	$7,141.10	$10,276.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,106.72 / $2,106.72 / $2,106.72	Professional		$2,106.72	$2,106.72	$2,106.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $330.98 / $1,098.66 / $1,370.23	Facility		$330.98	$1,098.66	$1,370.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $511.00 / $700.00 / $1,067.99	Professional		$511.00	$700.00	$1,067.99
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,586.25 / $2,586.25 / $2,586.25	Professional		$2,586.25	$2,586.25	$2,586.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $654.94 / $1,096.18 / $1,096.18	Professional		$654.94	$1,096.18	$1,096.18
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $480.00	Facility		$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $465.52 / $513.53 / $1,301.67	Professional		$465.52	$513.53	$1,301.67