Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.48 / $165.60 / $494.08	Facility		$73.48	$165.60	$494.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $76.81 / $220.42	Professional		$73.48	$76.81	$220.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $334.94 / $334.94 / $334.94	Professional		$334.94	$334.94	$334.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.88 / $362.95 / $876.00	Facility		$32.88	$362.95	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $34.57 / $101.92	Professional		$31.22	$34.57	$101.92
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $52.91 / $92.60 / $280.63	Facility		$52.91	$92.60	$280.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $24.00 / $68.23	Professional		$16.80	$24.00	$68.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.38 / $98.96 / $178.19	Facility		$46.38	$98.96	$178.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $58.40 / $79.68	Professional		$54.75	$58.40	$79.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $63.59 / $73.13 / $94.89	Professional		$63.59	$73.13	$94.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $80.83 / $159.29	Professional		$63.26	$80.83	$159.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $122.30 / $333.88 / $333.88	Facility		$122.30	$333.88	$333.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $350.04 / $350.04 / $527.17	Professional		$350.04	$350.04	$527.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $65.34 / $84.35 / $167.62	Facility		$65.34	$84.35	$167.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $69.95 / $111.28	Professional		$35.58	$69.95	$111.28
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.29 / $108.10	Professional		$56.23	$70.29	$108.10
United Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $37.27 / $190.40	Professional		$34.15	$37.27	$190.40