Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.96 / $128.02 / $150.61	Facility		$112.96	$128.02	$150.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.69 / $138.61 / $305.00	Professional		$102.69	$138.61	$305.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $442.00 / $442.00 / $442.00	Professional	25	$442.00	$442.00	$442.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $129.40 / $206.34	Professional		$90.00	$129.40	$206.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.72 / $157.77 / $157.77	Facility		$146.72	$157.77	$157.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.55 / $145.19 / $258.49	Professional		$100.55	$145.19	$258.49
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 $94.50 / $169.34 / $279.42	Professional		$94.50	$169.34	$279.42
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 $87.00 / $135.00 / $258.69	Professional		$87.00	$135.00	$258.69
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $98.02 / $149.56 / $209.38	Professional		$98.02	$149.56	$209.38
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $94.79 / $128.00 / $233.12	Professional		$94.79	$128.00	$233.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $154.50 / $259.16	Professional		$110.00	$154.50	$259.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $629.74 / $672.17 / $1,400.00	Facility		$629.74	$672.17	$1,400.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $858.92 / $966.24 / $1,269.83	Professional		$858.92	$966.24	$1,269.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $182.53 / $264.79	Professional		$32.34	$182.53	$264.79
Optum Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $146.88 / $230.08	Professional		$104.11	$146.88	$230.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $160.69 / $213.07	Facility		$130.00	$160.69	$213.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $126.00 / $231.49	Professional		$86.00	$126.00	$231.49
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $163.00 / $224.00	Facility		$100.00	$163.00	$224.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $147.07 / $247.40	Professional		$107.04	$147.07	$247.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $136.02 / $161.51 / $197.40	Professional		$136.02	$161.51	$197.40
United Facility/Professional Facility Modifier Low / Median / High Price $174.96 / $174.96 / $174.96	Facility		$174.96	$174.96	$174.96
United Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $147.07 / $389.85	Professional		$102.95	$147.07	$389.85