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 $78.00 / $101.06 / $176.80	Professional		$78.00	$101.06	$176.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $86.69 / $151.71	Professional		$62.42	$86.69	$151.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.41 / $139.13 / $139.13	Facility		$129.41	$139.13	$139.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.52 / $126.00 / $225.31	Professional		$81.52	$126.00	$225.31
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $194.05 / $294.18	Facility		$87.40	$194.05	$294.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $111.10 / $212.06	Professional		$81.59	$111.10	$212.06
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 $75.00 / $107.07 / $194.79	Professional		$75.00	$107.07	$194.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.65 / $114.73 / $154.28	Professional		$89.65	$114.73	$154.28
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $101.00 / $151.72	Professional		$70.00	$101.00	$151.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.49 / $106.08 / $188.97	Professional		$85.49	$106.08	$188.97
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $479.89 / $512.91 / $512.91	Facility		$479.89	$512.91	$512.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $653.17 / $663.21 / $839.55	Professional		$653.17	$663.21	$839.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $150.60 / $173.91	Professional		$32.34	$150.60	$173.91
Optum Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $114.41 / $180.20	Professional		$87.18	$114.41	$180.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.27 / $126.26 / $161.12	Facility		$97.27	$126.26	$161.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $99.00 / $177.00	Professional		$67.00	$99.00	$177.00
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $135.00 / $208.00	Facility		$80.00	$135.00	$208.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $116.25 / $190.00	Professional		$91.00	$116.25	$190.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $92.76 / $104.36 / $127.55	Professional		$92.76	$104.36	$127.55
United Facility/Professional Facility Modifier Low / Median / High Price $55.89 / $55.89 / $117.53	Facility		$55.89	$55.89	$117.53
United Facility/Professional Professional Modifier Low / Median / High Price $83.16 / $114.41 / $237.50	Professional		$83.16	$114.41	$237.50