Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $2,951.21	Facility		$309.03	$309.03	$2,951.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $2,951.21	Professional		$234.42	$309.03	$2,951.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $512.86 / $562.34	Professional		$501.19	$512.86	$562.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $295.12 / $1,348.96	Facility		$234.42	$295.12	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $741.31	Professional		$309.03	$309.03	$741.31
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,174.90 / $1,584.89	Facility		$100.00	$1,174.90	$1,584.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,288.25 / $2,187.76	Professional		$660.69	$1,288.25	$2,187.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $363.08 / $363.08	Facility		$316.23	$363.08	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $363.08	Professional		$263.03	$263.03	$363.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $323.59 / $831.76	Professional		$257.04	$323.59	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $630.96 / $1,096.48	Professional		$416.87	$630.96	$1,096.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $3,235.94 / $3,235.94	Facility		$3,235.94	$3,235.94	$3,235.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $4,365.16 / $4,365.16	Professional		$3,548.13	$4,365.16	$4,365.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $575.44 / $831.76	Facility		$199.53	$575.44	$831.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $501.19	Professional		$263.03	$263.03	$501.19
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional		$1,288.25	$1,288.25	$1,288.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $630.96	Professional		$257.04	$389.05	$630.96
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $251.19 / $691.83	Facility		$41.69	$251.19	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $295.12 / $691.83	Professional		$234.42	$295.12	$691.83