Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $154.88 / $758.58	Facility		$141.25	$154.88	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $426.58	Professional		$125.89	$147.91	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $173.78 / $173.78	Facility		$151.36	$173.78	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $218.78 / $380.19	Professional		$151.36	$218.78	$380.19
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $165.96 / $602.56	Facility		$66.07	$165.96	$602.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $190.55 / $346.74	Professional		$141.25	$190.55	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $389.05 / $1,174.90	Facility		$309.03	$389.05	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $346.74	Professional		$147.91	$190.55	$346.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $144.54 / $177.83	Professional		$131.83	$144.54	$177.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $302.00	Professional		$107.15	$123.03	$302.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,096.48 / $1,096.48	Professional		$870.96	$1,096.48	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Optum Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $39.81	Professional		$30.90	$30.90	$39.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $158.49 / $288.40	Facility		$120.23	$158.49	$288.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $346.74	Professional		$147.91	$190.55	$346.74
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $354.81 / $549.54	Facility		$338.84	$354.81	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $288.40	Professional		$112.20	$154.88	$288.40