Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $331.13 / $933.25	Facility		$141.25	$331.13	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $416.87	Professional		$79.43	$141.25	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $229.09	Professional		$112.20	$112.20	$229.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $74.13 / $724.44	Facility		$66.07	$74.13	$724.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $128.82	Professional		$63.10	$69.18	$128.82
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $331.13 / $1,380.38	Facility		$69.18	$331.13	$1,380.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $169.82	Professional		$57.54	$75.86	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $213.80 / $616.60	Facility		$97.72	$213.80	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $162.18 / $346.74	Professional		$85.11	$162.18	$346.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $213.80	Professional		$141.25	$158.49	$213.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $323.59	Professional		$128.82	$158.49	$323.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,071.52 / $1,071.52	Professional		$707.95	$1,071.52	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $169.82 / $363.08	Facility		$141.25	$169.82	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $158.49 / $323.59	Professional		$85.11	$158.49	$323.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $2,137.96	Professional		$114.82	$158.49	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $141.25 / $141.25	Facility		$60.26	$141.25	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $70.79 / $346.74	Professional		$66.07	$70.79	$346.74