Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $518.32 / $518.32 / $3,062.66	Facility		$518.32	$518.32	$3,062.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.07 / $518.32 / $3,062.66	Professional		$386.07	$518.32	$3,062.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $674.99 / $674.99 / $674.99	Professional		$674.99	$674.99	$674.99
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $393.62 / $1,532.15 / $3,369.49	Facility		$393.62	$1,532.15	$3,369.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $520.50 / $836.99	Professional		$450.91	$520.50	$836.99
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $1,256.70 / $2,244.11	Facility		$98.20	$1,256.70	$2,244.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,408.41 / $3,280.70	Professional		$100.00	$1,408.41	$3,280.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $496.48 / $582.20 / $582.20	Facility		$496.48	$582.20	$582.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $425.01 / $620.66	Professional		$425.01	$425.01	$620.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $417.97 / $501.56 / $1,167.64	Professional		$417.97	$501.56	$1,167.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $636.89 / $743.04 / $1,613.46	Professional		$636.89	$743.04	$1,613.46
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,826.98 / $5,042.08 / $5,042.08	Facility		$1,826.98	$5,042.08	$5,042.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,695.77 / $5,695.77 / $6,472.50	Professional		$5,695.77	$5,695.77	$6,472.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,358.85 / $2,358.85 / $2,358.85	Professional		$2,358.85	$2,358.85	$2,358.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $277.95 / $906.15 / $1,114.56	Facility		$277.95	$906.15	$1,114.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $425.01 / $582.20 / $875.93	Professional		$425.01	$582.20	$875.93
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,003.52 / $2,003.52 / $2,003.52	Professional		$2,003.52	$2,003.52	$2,003.52
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $417.97 / $710.55 / $849.19	Professional		$417.97	$710.55	$849.19
United Facility/Professional Facility Modifier Low / Median / High Price $500.36 / $500.36 / $500.36	Facility		$500.36	$500.36	$500.36
United Facility/Professional Professional Modifier Low / Median / High Price $409.70 / $518.84 / $1,070.96	Professional		$409.70	$518.84	$1,070.96