Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $486.62 / $486.62 / $3,116.86	Facility		$486.62	$486.62	$3,116.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $432.86 / $486.62 / $1,233.85	Professional		$432.86	$486.62	$1,233.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $524.74 / $734.58 / $799.40	Professional		$524.74	$734.58	$799.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $369.53 / $1,522.32 / $3,429.10	Facility		$369.53	$1,522.32	$3,429.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.64 / $492.70 / $813.34	Professional		$426.64	$492.70	$813.34
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,278.94 / $2,283.82	Facility		$97.00	$1,278.94	$2,283.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,433.34 / $3,338.71	Professional		$100.00	$1,433.34	$3,338.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $504.92 / $510.00 / $577.45	Facility		$504.92	$510.00	$577.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.30 / $372.30 / $543.69	Professional		$372.30	$372.30	$543.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $392.52 / $471.02 / $1,188.30	Professional		$392.52	$471.02	$1,188.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $648.16 / $756.19 / $1,642.01	Professional		$648.16	$756.19	$1,642.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,566.39 / $4,248.13 / $5,131.28	Facility		$1,566.39	$4,248.13	$5,131.28
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,185.30 / $5,282.69 / $6,232.88	Professional		$5,185.30	$5,282.69	$6,232.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,025.11 / $2,025.11 / $2,025.11	Professional		$2,025.11	$2,025.11	$2,025.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $260.95 / $918.23 / $1,080.27	Facility		$260.95	$918.23	$1,080.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $372.30 / $510.00 / $867.13	Professional		$372.30	$510.00	$867.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,038.98 / $2,038.98 / $2,038.98	Professional		$2,038.98	$2,038.98	$2,038.98
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $392.52 / $667.28 / $864.22	Professional		$392.52	$667.28	$864.22
United Facility/Professional Professional Modifier Low / Median / High Price $373.72 / $404.86 / $962.63	Professional		$373.72	$404.86	$962.63