Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.75 / $34.85 / $54.34	Facility		$30.75	$34.85	$54.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.75 / $34.70 / $66.13	Professional		$19.75	$34.70	$66.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $96.00 / $96.00 / $96.00	Professional	25	$96.00	$96.00	$96.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $26.42 / $52.85	Professional		$17.38	$26.42	$52.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.97 / $40.82 / $40.82	Facility		$37.97	$40.82	$40.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.87 / $37.57 / $68.02	Professional		$21.87	$37.57	$68.02
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.72 / $76.02 / $130.87	Facility		$63.72	$76.02	$130.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $44.44 / $67.70	Professional		$31.36	$44.44	$67.70
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 $21.00 / $31.00 / $62.31	Professional		$21.00	$31.00	$62.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $26.84 / $38.92	Professional		$3.47	$26.84	$38.92
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $42.11 / $56.12 / $56.88	Professional		$42.11	$56.12	$56.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.06 / $27.07 / $46.02	Professional		$22.06	$27.07	$46.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $113.54 / $120.84 / $1,200.00	Facility		$113.54	$120.84	$1,200.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $154.04 / $232.58 / $408.25	Professional		$154.04	$232.58	$408.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.08 / $105.00	Professional		$32.34	$40.08	$105.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $28.97 / $40.00 / $77.40	Professional		$28.97	$40.00	$77.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.74 / $36.06 / $52.84	Facility		$24.74	$36.06	$52.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $30.59 / $55.00	Professional		$22.00	$30.59	$55.00
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $50.00 / $77.00	Facility		$42.00	$50.00	$77.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $27.47 / $45.42 / $96.04	Professional		$27.47	$45.42	$96.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $24.40 / $29.41 / $35.95	Professional		$24.40	$29.41	$35.95
United Facility/Professional Facility Modifier Low / Median / High Price $31.78 / $31.78 / $31.78	Facility		$31.78	$31.78	$31.78
United Facility/Professional Professional Modifier Low / Median / High Price $23.40 / $40.00 / $77.73	Professional		$23.40	$40.00	$77.73