Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.50 / $110.50 / $130.00	Facility		$97.50	$110.50	$130.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.69 / $97.50 / $155.83	Professional		$73.69	$97.50	$155.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.22 / $93.50 / $153.91	Professional		$67.22	$93.50	$153.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.20 / $116.34 / $116.34	Facility		$108.20	$116.34	$116.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.15 / $109.29 / $185.80	Professional		$72.15	$109.29	$185.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $169.10 / $294.18	Facility		$87.40	$169.10	$294.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $133.06 / $218.19	Professional		$83.86	$133.06	$218.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Facility		$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $98.00 / $181.85	Professional		$70.00	$98.00	$181.85
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $86.64 / $109.95 / $147.81	Professional		$86.64	$109.95	$147.81
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $109.60 / $109.60	Professional		$50.00	$109.60	$109.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $100.72 / $181.13	Professional		$85.00	$100.72	$181.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $460.18 / $491.63 / $491.63	Facility		$460.18	$491.63	$491.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $625.23 / $636.03 / $805.43	Professional		$625.23	$636.03	$805.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $144.88 / $165.66	Professional		$32.34	$144.88	$165.66
Optum Facility/Professional Professional Modifier Low / Median / High Price $83.80 / $109.97 / $180.00	Professional		$83.80	$109.97	$180.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.15 / $120.48 / $152.75	Facility		$93.15	$120.48	$152.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $94.60 / $158.00	Professional		$70.00	$94.60	$158.00
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $135.00 / $190.00	Facility		$80.00	$135.00	$190.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $110.22 / $182.08	Professional		$87.14	$110.22	$182.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $88.88 / $99.99 / $122.21	Professional		$88.88	$99.99	$122.21
United Facility/Professional Facility Modifier Low / Median / High Price $78.56 / $78.56 / $112.17	Facility		$78.56	$78.56	$112.17
United Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $109.96 / $237.39	Professional		$77.48	$109.96	$237.39