Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $586.95 / $586.95 / $2,656.81	Facility		$586.95	$586.95	$2,656.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.66 / $586.95 / $739.55	Professional		$398.66	$586.95	$739.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $480.87 / $521.19 / $582.00	Professional		$480.87	$521.19	$582.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $649.71 / $891.39 / $2,268.63	Facility		$649.71	$891.39	$2,268.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $632.66 / $653.37 / $733.69	Professional		$632.66	$653.37	$733.69
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $553.55 / $2,159.13	Facility		$92.60	$553.55	$2,159.13
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $513.58 / $733.69 / $1,180.95	Professional		$513.58	$733.69	$1,180.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.29 / $647.80 / $647.82	Facility		$621.29	$647.80	$647.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.90 / $472.90 / $713.63	Professional		$472.90	$472.90	$713.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $502.25 / $586.95 / $704.34	Professional		$502.25	$586.95	$704.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $390.64 / $561.02 / $1,218.20	Professional		$390.64	$561.02	$1,218.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,207.57 / $3,006.95 / $3,006.95	Facility		$1,207.57	$3,006.95	$3,006.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,196.00 / $4,196.00 / $4,633.35	Professional		$4,196.00	$4,196.00	$4,633.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $1,410.85	Professional		$70.00	$70.00	$1,410.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $406.36 / $558.05 / $647.82	Facility		$406.36	$558.05	$647.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $472.90 / $472.90 / $650.16	Professional		$472.90	$472.90	$650.16
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,738.02 / $1,738.02 / $1,738.02	Professional		$1,738.02	$1,738.02	$1,738.02
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $446.45 / $586.95 / $763.04	Professional		$446.45	$586.95	$763.04
United Facility/Professional Professional Modifier Low / Median / High Price $403.53 / $459.39 / $921.31	Professional		$403.53	$459.39	$921.31