Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.28 / $146.51 / $180.63	Facility		$129.28	$146.51	$180.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.07 / $166.77 / $325.12	Professional		$125.07	$166.77	$325.12
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.37 / $172.37 / $172.37	Professional	25	$172.37	$172.37	$172.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.55 / $187.93 / $347.35	Professional		$130.55	$187.93	$347.35
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $187.93 / $187.93 / $187.93	Professional	25	$187.93	$187.93	$187.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $196.75 / $211.55 / $211.55	Facility		$196.75	$211.55	$211.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.43 / $193.24 / $349.12	Professional		$108.43	$193.24	$349.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $185.51 / $267.10 / $267.10	Facility		$185.51	$267.10	$267.10
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $160.65 / $229.50 / $328.88	Professional		$160.65	$229.50	$328.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.62 / $181.68 / $410.00	Professional		$108.62	$181.68	$410.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $103.25 / $182.67 / $271.38	Professional		$103.25	$182.67	$271.38
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $158.19 / $280.77 / $500.70	Professional		$158.19	$280.77	$500.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $145.31 / $181.20 / $310.25	Professional		$145.31	$181.20	$310.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $765.98 / $818.71 / $818.71	Facility		$765.98	$818.71	$818.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,080.07 / $1,234.10 / $1,560.60	Professional		$1,080.07	$1,234.10	$1,560.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.00 / $336.67	Professional		$32.34	$60.00	$336.67
Optum Facility/Professional Professional Modifier Low / Median / High Price $138.52 / $187.85 / $271.85	Professional		$138.52	$187.85	$271.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $159.12 / $192.72 / $259.23	Facility		$159.12	$192.72	$259.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $174.87 / $385.34	Professional		$99.00	$174.87	$385.34
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $189.11 / $275.00	Facility		$150.00	$189.11	$275.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $140.04 / $190.23 / $274.00	Professional		$140.04	$190.23	$274.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $166.09 / $197.42 / $241.29	Professional		$166.09	$197.42	$241.29
United Facility/Professional Facility Modifier Low / Median / High Price $222.81 / $222.81 / $222.81	Facility		$222.81	$222.81	$222.81
United Facility/Professional Professional Modifier Low / Median / High Price $120.42 / $180.00 / $400.00	Professional		$120.42	$180.00	$400.00