Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.27 / $720.00 / $1,503.13	Facility		$259.27	$720.00	$1,503.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.76 / $242.61 / $326.68	Professional		$223.76	$242.61	$326.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.00 / $251.54 / $420.00	Professional		$168.00	$251.54	$420.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.44 / $293.00 / $876.00	Facility		$99.44	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.22 / $520.96 / $1,070.33	Professional		$315.22	$520.96	$1,070.33
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $426.90 / $838.65	Facility		$97.00	$426.90	$838.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $207.73 / $296.76 / $661.24	Professional		$207.73	$296.76	$661.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.46 / $310.38 / $587.45	Facility		$200.46	$310.38	$587.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.35 / $357.85 / $765.42	Professional		$229.35	$357.85	$765.42
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $243.52 / $243.52 / $292.22	Professional		$243.52	$243.52	$292.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.99 / $335.99 / $590.96	Professional		$251.99	$335.99	$590.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $533.69 / $1,165.65 / $1,333.47	Facility		$533.69	$1,165.65	$1,333.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,550.91 / $1,550.91 / $2,151.08	Professional		$1,550.91	$1,550.91	$2,151.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $231.06 / $327.20 / $447.98	Facility		$231.06	$327.20	$447.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $243.72 / $352.73 / $625.89	Professional		$243.72	$352.73	$625.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $286.18 / $321.95 / $413.99	Professional		$286.18	$321.95	$413.99
United Facility/Professional Facility Modifier Low / Median / High Price $321.77 / $321.77 / $321.77	Facility		$321.77	$321.77	$321.77
United Facility/Professional Professional Modifier Low / Median / High Price $191.10 / $265.76 / $710.99	Professional		$191.10	$265.76	$710.99