Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $755.89 / $755.89 / $4,841.62	Facility		$755.89	$755.89	$4,841.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $655.45 / $755.89 / $2,101.37	Professional		$655.45	$755.89	$2,101.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,124.30 / $1,124.30 / $1,241.76	Professional		$1,124.30	$1,124.30	$1,241.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $574.01 / $2,364.71 / $5,326.67	Facility		$574.01	$2,364.71	$5,326.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $659.13 / $828.15 / $1,311.05	Professional		$659.13	$828.15	$1,311.05
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,986.68 / $3,547.64	Facility		$97.00	$1,986.68	$3,547.64
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $2,226.50 / $5,186.28	Professional		$100.00	$2,226.50	$5,186.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $745.41 / $840.60 / $852.48	Facility		$745.41	$840.60	$852.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $613.64 / $613.64 / $896.12	Professional		$613.64	$613.64	$896.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $644.44 / $773.33 / $1,845.87	Professional		$644.44	$773.33	$1,845.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,006.84 / $1,174.64 / $2,550.65	Professional		$1,006.84	$1,174.64	$2,550.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,433.19 / $6,648.31 / $7,970.79	Facility		$2,433.19	$6,648.31	$7,970.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,054.69 / $8,087.45 / $11,389.50	Professional		$8,054.69	$8,087.45	$11,389.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,970.91 / $3,970.91 / $3,970.91	Professional		$3,970.91	$3,970.91	$3,970.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $405.35 / $1,322.34 / $1,678.06	Facility		$405.35	$1,322.34	$1,678.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $613.64 / $840.60 / $1,406.62	Professional		$613.64	$840.60	$1,406.62
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,167.28 / $3,167.28 / $3,167.28	Professional		$3,167.28	$3,167.28	$3,167.28
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $644.44 / $1,095.55 / $1,342.45	Professional		$644.44	$1,095.55	$1,342.45
United Facility/Professional Professional Modifier Low / Median / High Price $580.52 / $638.88 / $1,633.18	Professional		$580.52	$638.88	$1,633.18