Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $40.74 / $416.87	Facility		$30.90	$40.74	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $40.74 / $107.15	Professional		$20.42	$40.74	$107.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $95.50 / $95.50	Professional	25	$64.57	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $23.44 / $34.67	Professional		$18.20	$23.44	$34.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $40.74	Facility		$38.02	$38.02	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $47.86 / $74.13	Professional		$25.70	$47.86	$74.13
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $63.10 / $91.20	Facility		$22.91	$63.10	$91.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $85.11	Professional		$33.88	$44.67	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $60.26	Professional		$20.89	$30.90	$60.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $26.92 / $43.65	Professional		$3.47	$26.92	$43.65
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $109.65	Professional		$31.62	$45.71	$109.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.18 / $40.74	Professional		$22.39	$28.18	$40.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $407.38	Professional		$234.42	$234.42	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $43.65 / $104.71	Professional		$39.81	$43.65	$104.71
Optum Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $70.79	Professional		$29.51	$40.74	$70.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $38.90 / $60.26	Facility		$24.55	$38.90	$60.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $30.90 / $60.26	Professional		$20.42	$30.90	$60.26
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $89.13	Professional		$79.43	$79.43	$89.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $24.55 / $39.81	Professional		$4.17	$24.55	$39.81
United Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $40.74 / $42.66	Facility		$39.81	$40.74	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $64.57	Professional		$20.89	$32.36	$64.57