Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $808.66 / $2,117.00	Facility		$173.78	$808.66	$2,117.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.27 / $208.44 / $814.41	Professional		$162.27	$208.44	$814.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.78 / $264.12 / $445.49	Professional		$165.78	$264.12	$445.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.00 / $220.76 / $1,704.00	Facility		$186.00	$220.76	$1,704.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.10 / $248.25 / $515.49	Professional		$195.10	$248.25	$515.49
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $136.38 / $195.79 / $482.02	Professional		$136.38	$195.79	$482.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $734.31 / $817.28 / $968.02	Facility		$734.31	$817.28	$968.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.41 / $225.47 / $522.65	Professional		$160.41	$225.47	$522.65
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $114.37 / $222.09 / $299.82	Professional		$114.37	$222.09	$299.82
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $505.64 / $505.64 / $505.64	Professional		$505.64	$505.64	$505.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.50 / $233.93 / $447.52	Professional		$180.50	$233.93	$447.52
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $966.25 / $966.25	Facility		$500.00	$966.25	$966.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,821.00 / $1,821.00 / $1,821.00	Professional		$1,821.00	$1,821.00	$1,821.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $180.69 / $244.10 / $574.78	Facility		$180.69	$244.10	$574.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.41 / $228.44 / $494.53	Professional		$160.41	$228.44	$494.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $623.16 / $623.16 / $623.16	Professional		$623.16	$623.16	$623.16
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $171.56 / $229.67 / $278.89	Professional		$171.56	$229.67	$278.89
United Facility/Professional Professional Modifier Low / Median / High Price $144.62 / $245.41 / $546.48	Professional		$144.62	$245.41	$546.48