Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $149.25 / $350.00	Professional		$88.87	$149.25	$350.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $133.31 / $167.22 / $350.00	Professional	25	$133.31	$167.22	$350.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $142.91 / $356.37	Professional		$120.00	$142.91	$356.37
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $98.50 / $133.44 / $318.16	Professional	25	$98.50	$133.44	$318.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.49 / $97.49 / $97.49	Facility		$97.49	$97.49	$97.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.69 / $127.56 / $297.32	Professional		$85.69	$127.56	$297.32
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.10 / $239.33 / $651.04	Facility		$95.10	$239.33	$651.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $69.81 / $103.55 / $193.20	Professional		$69.81	$103.55	$193.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.95 / $144.31 / $302.92	Professional		$86.95	$144.31	$302.92
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $49.78 / $116.53 / $200.34	Professional		$49.78	$116.53	$200.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.24 / $151.36 / $281.94	Professional		$92.24	$151.36	$281.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $417.83 / $460.75 / $460.75	Facility		$417.83	$460.75	$460.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $592.72 / $740.85 / $1,210.43	Professional		$592.72	$740.85	$1,210.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $131.34 / $220.96	Facility		$80.00	$131.34	$220.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.93 / $153.66 / $323.63	Professional		$90.93	$153.66	$323.63
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $321.08 / $321.08 / $496.60	Professional		$321.08	$321.08	$496.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $96.37 / $117.79 / $202.54	Professional		$96.37	$117.79	$202.54
United Facility/Professional Facility Modifier Low / Median / High Price $101.25 / $101.25 / $101.25	Facility		$101.25	$101.25	$101.25
United Facility/Professional Professional Modifier Low / Median / High Price $99.47 / $135.36 / $273.93	Professional		$99.47	$135.36	$273.93