Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.74 / $64.30 / $75.65	Facility		$56.74	$64.30	$75.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $69.06 / $156.93	Professional		$53.77	$69.06	$156.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.75 / $69.90 / $118.22	Professional		$43.75	$69.90	$118.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.81 / $83.66 / $83.66	Facility		$77.81	$83.66	$83.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.57 / $76.42 / $136.50	Professional		$48.57	$76.42	$136.50
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $143.71 / $206.92 / $206.92	Facility		$143.71	$206.92	$206.92
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $86.93 / $138.13	Professional		$57.17	$86.93	$138.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $262.00	Facility		$200.00	$200.00	$262.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $68.00 / $123.00	Professional		$50.00	$68.00	$123.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $52.87 / $80.45 / $111.06	Professional		$52.87	$80.45	$111.06
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $63.33 / $101.33 / $210.14	Professional		$63.33	$101.33	$210.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $77.31 / $132.57	Professional		$59.75	$77.31	$132.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $322.45 / $344.23 / $344.23	Facility		$322.45	$344.23	$344.23
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $440.01 / $494.51 / $649.35	Professional		$440.01	$494.51	$649.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $91.26 / $136.19	Professional		$32.34	$91.26	$136.19
Optum Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $75.56 / $118.00	Professional		$51.92	$75.56	$118.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.64 / $81.25 / $108.41	Facility		$67.64	$81.25	$108.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $65.51 / $111.86	Professional		$46.00	$65.51	$111.86
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $115.00 / $142.00	Facility		$55.00	$115.00	$142.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $75.91 / $123.97	Professional		$55.00	$75.91	$123.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $69.66 / $82.61 / $100.97	Professional		$69.66	$82.61	$100.97
United Facility/Professional Facility Modifier Low / Median / High Price $89.97 / $89.97 / $89.97	Facility		$89.97	$89.97	$89.97
United Facility/Professional Professional Modifier Low / Median / High Price $53.19 / $75.56 / $160.63	Professional		$53.19	$75.56	$160.63