Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.30 / $85.35 / $151.61	Professional		$47.30	$85.35	$151.61
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $76.23 / $94.52 / $192.97	Professional	25	$76.23	$94.52	$192.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $81.81 / $214.54	Professional		$72.70	$81.81	$214.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $72.70 / $82.41 / $93.51	Professional	25	$72.70	$82.41	$93.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.20 / $50.20 / $50.20	Facility		$50.20	$50.20	$50.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $71.40 / $163.72	Professional		$44.52	$71.40	$163.72
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.10 / $144.58 / $393.32	Facility		$95.10	$144.58	$393.32
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $51.12 / $100.00	Professional		$29.57	$51.12	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $79.73 / $174.99	Professional		$42.93	$79.73	$174.99
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $62.85 / $121.42	Professional		$37.15	$62.85	$121.42
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $100.44 / $100.44 / $100.44	Professional		$100.44	$100.44	$100.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $90.66 / $169.66	Professional		$49.46	$90.66	$169.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $224.03 / $247.71 / $247.71	Facility		$224.03	$247.71	$247.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $325.91 / $399.68 / $727.80	Professional		$325.91	$399.68	$727.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $479.00 / $479.00 / $479.00	Professional		$479.00	$479.00	$479.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $43.08 / $70.88 / $131.29	Facility		$43.08	$70.88	$131.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $84.20 / $178.30	Professional		$42.93	$84.20	$178.30
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $170.43 / $293.05	Professional		$170.43	$170.43	$293.05
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $51.97 / $63.51 / $122.75	Professional		$51.97	$63.51	$122.75
United Facility/Professional Facility Modifier Low / Median / High Price $85.05 / $85.05 / $85.05	Facility		$85.05	$85.05	$85.05
United Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $77.19 / $187.74	Professional		$55.22	$77.19	$187.74