Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $576.86 / $576.86 / $3,027.75	Facility		$576.86	$576.86	$3,027.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.51 / $576.86 / $946.56	Professional		$461.51	$576.86	$946.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $604.77 / $604.77 / $891.99	Professional		$604.77	$604.77	$891.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $438.05 / $1,592.09 / $3,331.11	Facility		$438.05	$1,592.09	$3,331.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $524.50 / $580.35 / $999.88	Professional		$524.50	$580.35	$999.88
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,242.40 / $2,218.56	Facility		$97.00	$1,242.40	$2,218.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,392.37 / $3,243.30	Professional		$100.00	$1,392.37	$3,243.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $731.38 / $731.38 / $833.65	Facility		$731.38	$731.38	$833.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $533.91 / $860.28	Professional		$533.91	$533.91	$860.28
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $560.94 / $673.13 / $1,154.33	Professional		$560.94	$673.13	$1,154.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $629.64 / $734.58 / $1,595.09	Professional		$629.64	$734.58	$1,595.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,806.24 / $5,006.71 / $5,006.71	Facility		$1,806.24	$5,006.71	$5,006.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,412.81 / $5,412.81 / $7,870.50	Professional		$5,412.81	$5,412.81	$7,870.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,245.97 / $3,245.97 / $3,245.97	Professional		$3,245.97	$3,245.97	$3,245.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $309.33 / $927.76 / $1,080.93	Facility		$309.33	$927.76	$1,080.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $731.38 / $998.83	Professional		$533.91	$731.38	$998.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,980.68 / $1,980.68 / $1,980.68	Professional		$1,980.68	$1,980.68	$1,980.68
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $560.94 / $839.52 / $841.41	Professional		$560.94	$839.52	$841.41
United Facility/Professional Professional Modifier Low / Median / High Price $435.08 / $479.17 / $1,049.40	Professional		$435.08	$479.17	$1,049.40