Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.79 / $345.46 / $1,794.71	Facility		$152.79	$345.46	$1,794.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.86 / $169.09 / $1,110.65	Professional		$110.86	$169.09	$1,110.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $823.08 / $823.08 / $823.08	Professional		$823.08	$823.08	$823.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.10 / $353.00 / $865.38	Facility		$177.10	$353.00	$865.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $378.50 / $762.38	Professional		$73.73	$378.50	$762.38
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $124.88 / $487.10	Facility		$92.60	$124.88	$487.10
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $92.55 / $132.22 / $245.15	Professional		$92.55	$132.22	$245.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.87 / $298.64 / $578.19	Facility		$126.87	$298.64	$578.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.49 / $126.11 / $535.85	Professional		$92.49	$126.11	$535.85
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $172.73 / $190.00 / $233.19	Professional		$172.73	$190.00	$233.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.46 / $198.64 / $391.44	Professional		$155.46	$198.64	$391.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $300.55 / $820.47 / $820.47	Facility		$300.55	$820.47	$820.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $863.65 / $863.65 / $1,295.48	Professional		$863.65	$863.65	$1,295.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $207.28 / $207.28 / $207.28	Professional		$207.28	$207.28	$207.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $148.19 / $222.29 / $496.35	Facility		$148.19	$222.29	$496.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.56 / $198.64 / $457.66	Professional		$110.56	$198.64	$457.66
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $606.28 / $606.28 / $606.28	Professional		$606.28	$606.28	$606.28
United Facility/Professional Professional Modifier Low / Median / High Price $72.55 / $85.56 / $534.82	Professional		$72.55	$85.56	$534.82