Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.22 / $128.34 / $280.29	Professional		$63.22	$128.34	$280.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $28.64 / $133.72 / $300.00	Professional	25	$28.64	$133.72	$300.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.61 / $128.34 / $302.68	Professional		$102.61	$128.34	$302.68
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $101.25 / $112.72 / $286.07	Professional	25	$101.25	$112.72	$286.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.68 / $76.68 / $76.68	Facility		$76.68	$76.68	$76.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $104.03 / $242.95	Professional		$67.40	$104.03	$242.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.10 / $198.18 / $539.13	Facility		$95.10	$198.18	$539.13
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $48.30 / $79.73 / $143.88	Professional		$48.30	$79.73	$143.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $116.13 / $253.11	Professional		$65.11	$116.13	$253.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.43 / $94.48 / $170.72	Professional		$38.43	$94.48	$170.72
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $156.88 / $156.88 / $156.88	Professional		$156.88	$156.88	$156.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.52 / $128.34 / $239.42	Professional		$74.52	$128.34	$239.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $337.57 / $372.83 / $372.83	Facility		$337.57	$372.83	$372.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $476.78 / $600.75 / $1,027.88	Professional		$476.78	$600.75	$1,027.88
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 $64.66 / $104.17 / $186.24	Facility		$64.66	$104.17	$186.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $122.65 / $260.22	Professional		$66.86	$122.65	$260.22
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $258.17 / $258.17 / $416.86	Professional		$258.17	$258.17	$416.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $78.13 / $95.49 / $172.59	Professional		$78.13	$95.49	$172.59
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 $81.65 / $111.36 / $209.45	Professional		$81.65	$111.36	$209.45