Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $102.00 / $120.00	Facility		$90.00	$102.00	$120.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $93.61 / $185.07	Professional		$66.06	$93.61	$185.07
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.00 / $120.00 / $120.00	Professional	25	$120.00	$120.00	$120.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.46 / $98.93 / $170.37	Professional		$56.46	$98.93	$170.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.33 / $82.08 / $82.08	Facility		$76.33	$82.08	$82.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $72.14 / $133.01	Professional		$33.47	$72.14	$133.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $121.50 / $166.52	Professional		$85.05	$121.50	$166.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.00 / $98.00 / $220.04	Professional		$62.00	$98.00	$220.04
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $95.91 / $132.44	Professional		$56.02	$95.91	$132.44
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $190.00 / $351.92 / $558.16	Professional		$190.00	$351.92	$558.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $89.04 / $153.25	Professional		$71.45	$89.04	$153.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $383.01 / $409.36 / $409.36	Facility		$383.01	$409.36	$409.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $512.51 / $571.19 / $767.55	Professional		$512.51	$571.19	$767.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $131.78 / $158.13	Professional		$32.34	$131.78	$158.13
Optum Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $96.92 / $140.50	Professional		$78.23	$96.92	$140.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $79.94 / $109.61 / $141.85	Facility		$79.94	$109.61	$141.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $95.00 / $205.58	Professional		$57.00	$95.00	$205.58
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $101.00 / $115.00	Facility		$50.00	$101.00	$115.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $78.64 / $96.92 / $144.90	Professional		$78.64	$96.92	$144.90
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $83.04 / $96.83 / $118.35	Professional		$83.04	$96.83	$118.35
United Facility/Professional Facility Modifier Low / Median / High Price $104.51 / $104.51 / $104.51	Facility		$104.51	$104.51	$104.51
United Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $95.60 / $217.94	Professional		$65.95	$95.60	$217.94