Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $588.84 / $1,621.81	Facility		$131.83	$588.84	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $173.78 / $660.69	Professional		$95.50	$173.78	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $288.40	Professional		$151.36	$208.93	$288.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $37.15 / $707.95	Facility		$33.11	$37.15	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $316.23	Professional		$100.00	$138.04	$316.23
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $186.21 / $645.65	Facility		$66.07	$186.21	$645.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $338.84	Professional		$117.49	$177.83	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $281.84 / $524.81	Facility		$128.82	$281.84	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $346.74	Professional		$112.20	$173.78	$346.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $162.18 / $218.78	Professional		$75.86	$162.18	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $331.13	Professional		$128.82	$162.18	$331.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,047.13 / $1,047.13	Professional		$741.31	$1,047.13	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $93.33 / $154.88	Professional		$41.69	$93.33	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $165.96 / $288.40	Facility		$107.15	$165.96	$288.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $363.08	Professional		$112.20	$181.97	$363.08
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $144.54 / $218.78	Facility		$138.04	$144.54	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $302.00	Professional		$93.33	$144.54	$302.00