Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.50 / $93.50 / $110.00	Facility		$82.50	$93.50	$110.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $97.26 / $241.81	Professional		$74.50	$97.26	$241.81
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $403.26 / $403.26 / $403.26	Professional	25	$403.26	$403.26	$403.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $87.93 / $144.94	Professional		$60.21	$87.93	$144.94
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $85.00 / $85.00 / $85.00	Professional	25	$85.00	$85.00	$85.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.27 / $120.72 / $120.72	Facility		$112.27	$120.72	$120.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.18 / $106.11 / $194.88	Professional		$71.18	$106.11	$194.88
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 $85.41 / $133.06 / $216.22	Professional		$85.41	$133.06	$216.22
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 $70.00 / $94.00 / $173.00	Professional		$70.00	$94.00	$173.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.16 / $106.23 / $141.63	Professional		$67.16	$106.23	$141.63
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $106.72 / $243.07	Professional		$70.00	$106.72	$243.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $103.60 / $181.91	Professional		$78.84	$103.60	$181.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $425.37 / $454.43 / $1,400.00	Facility		$425.37	$454.43	$1,400.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $581.94 / $652.54 / $856.73	Professional		$581.94	$652.54	$856.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $136.90 / $233.09	Professional		$32.34	$136.90	$233.09
Optum Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $104.33 / $180.00	Professional		$78.66	$104.33	$180.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.50 / $112.56 / $149.76	Facility		$89.50	$112.56	$149.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $90.00 / $154.78	Professional		$73.00	$90.00	$154.78
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $103.00 / $215.00	Facility		$80.00	$103.00	$215.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $78.73 / $104.97 / $181.00	Professional		$78.73	$104.97	$181.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $92.02 / $109.14 / $133.40	Professional		$92.02	$109.14	$133.40
United Facility/Professional Facility Modifier Low / Median / High Price $118.68 / $118.68 / $118.68	Facility		$118.68	$118.68	$118.68
United Facility/Professional Professional Modifier Low / Median / High Price $73.36 / $103.17 / $222.52	Professional		$73.36	$103.17	$222.52