Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6.46 / $42.66 / $204.17	Facility		$6.46	$42.66	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $22.91 / $67.61	Professional		$16.98	$22.91	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $15.14 / $22.91	Professional		$11.75	$15.14	$22.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $58.88 / $128.82	Facility		$14.45	$58.88	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $21.88 / $81.28	Professional		$12.59	$21.88	$81.28
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $93.33 / $346.74	Facility		$52.48	$93.33	$346.74
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $29.51 / $81.28	Professional		$20.42	$29.51	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $42.66 / $93.33	Facility		$16.98	$42.66	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $25.70 / $42.66	Professional		$16.22	$25.70	$42.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $25.70 / $40.74	Professional		$22.39	$25.70	$40.74
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $56.23	Professional		$20.42	$25.70	$56.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $24.55 / $44.67	Professional		$21.88	$24.55	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $30.90 / $30.90	Professional		$15.14	$30.90	$30.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $30.90 / $75.86	Facility		$20.42	$30.90	$75.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $23.99 / $57.54	Professional		$15.14	$23.99	$57.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $43.65	Professional		$20.42	$25.70	$43.65
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $15.14 / $25.70	Facility		$11.48	$15.14	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $15.14 / $51.29	Professional		$10.72	$15.14	$51.29