Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $675.11 / $675.11 / $3,907.05	Facility		$675.11	$675.11	$3,907.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $492.13 / $675.11 / $3,907.05	Professional		$492.13	$675.11	$3,907.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,083.32 / $1,083.32 / $1,083.32	Professional		$1,083.32	$1,083.32	$1,083.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $512.66 / $1,954.58 / $4,298.47	Facility		$512.66	$1,954.58	$4,298.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $660.17 / $682.97 / $1,258.54	Professional		$660.17	$682.97	$1,258.54
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $1,603.19 / $2,862.83	Facility		$97.00	$1,603.19	$2,862.83
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,796.73 / $4,185.17	Professional		$100.00	$1,796.73	$4,185.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.36 / $702.38 / $723.84	Facility		$633.36	$702.38	$723.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.74 / $512.74 / $748.77	Professional		$512.74	$512.74	$748.77
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $502.11 / $602.53 / $1,489.57	Professional		$502.11	$602.53	$1,489.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $812.49 / $947.91 / $2,058.31	Professional		$812.49	$947.91	$2,058.31
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,747.14 / $6,432.21 / $6,432.21	Facility		$2,747.14	$6,432.21	$6,432.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,703.04 / $6,703.04 / $9,177.15	Professional		$6,703.04	$6,703.04	$9,177.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,304.32 / $2,304.32 / $2,304.32	Professional		$2,304.32	$2,304.32	$2,304.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $362.03 / $1,148.29 / $1,372.45	Facility		$362.03	$1,148.29	$1,372.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.74 / $702.38 / $1,288.90	Professional		$512.74	$702.38	$1,288.90
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,555.90 / $2,555.90 / $2,555.90	Professional		$2,555.90	$2,555.90	$2,555.90
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $502.11 / $853.59 / $1,083.32	Professional		$502.11	$853.59	$1,083.32
United Facility/Professional Professional Modifier Low / Median / High Price $531.38 / $658.63 / $1,366.23	Professional		$531.38	$658.63	$1,366.23