Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $865.70 / $865.70 / $4,158.76	Facility		$865.70	$865.70	$4,158.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $644.80 / $865.70 / $4,158.76	Professional		$644.80	$865.70	$4,158.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,153.10 / $1,153.10 / $1,287.55	Professional		$1,153.10	$1,153.10	$1,287.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $657.39 / $2,209.65 / $4,575.39	Facility		$657.39	$2,209.65	$4,575.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $837.49 / $874.06 / $1,596.56	Professional		$837.49	$874.06	$1,596.56
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,706.47 / $3,047.27	Facility		$97.00	$1,706.47	$3,047.27
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,912.48 / $4,454.82	Professional		$100.00	$1,912.48	$4,454.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $674.17 / $1,200.11 / $1,200.11	Facility		$674.17	$1,200.11	$1,200.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $876.09 / $1,407.32	Professional		$876.09	$876.09	$1,407.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $470.98 / $565.17 / $1,585.53	Professional		$470.98	$565.17	$1,585.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $864.83 / $1,008.97 / $2,190.91	Professional		$864.83	$1,008.97	$2,190.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,484.96 / $7,687.40 / $7,687.40	Facility		$3,484.96	$7,687.40	$7,687.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,570.81 / $9,570.81 / $10,810.43	Professional		$9,570.81	$9,570.81	$10,810.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,939.79 / $3,939.79 / $3,939.79	Professional		$3,939.79	$3,939.79	$3,939.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $464.23 / $1,274.32 / $1,513.46	Facility		$464.23	$1,274.32	$1,513.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $876.09 / $1,198.49 / $1,407.32	Professional		$876.09	$1,198.49	$1,407.32
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,720.57 / $2,720.57 / $2,720.57	Professional		$2,720.57	$2,720.57	$2,720.57
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $470.98 / $800.67 / $1,153.10	Professional		$470.98	$800.67	$1,153.10
United Facility/Professional Professional Modifier Low / Median / High Price $664.86 / $719.09 / $1,402.83	Professional		$664.86	$719.09	$1,402.83