Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $154.88	Professional		$30.20	$40.74	$154.88
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $97.72 / $204.17 / $229.09	Professional	22	$97.72	$204.17	$229.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.50 / $44.67 / $120.23	Professional	52	$19.50	$44.67	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $36.31 / $85.11	Professional		$29.51	$36.31	$85.11
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.00 / $10.00 / $38.02	Professional	52	$10.00	$10.00	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $138.04	Professional		$38.02	$57.54	$138.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $89.13	Professional		$42.66	$52.48	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $45.71 / $51.29	Facility		$38.02	$45.71	$51.29
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	52	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $47.86 / $97.72	Professional		$29.51	$47.86	$97.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $58.88	Professional		$32.36	$40.74	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $52.48	Professional		$23.99	$33.88	$52.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	52	$162.18	$162.18	$162.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $295.12 / $295.12	Professional		$60.26	$295.12	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $51.29	Professional		$30.90	$30.90	$51.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $38.02 / $66.07	Facility		$26.92	$38.02	$66.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $48.98 / $93.33	Professional		$29.51	$48.98	$93.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $125.89	Professional		$107.15	$107.15	$125.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $48.98	Professional		$26.92	$33.11	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $35.48 / $67.61	Professional		$26.30	$35.48	$67.61