Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.30 / $128.71 / $151.06	Facility		$113.30	$128.71	$151.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.08 / $128.40 / $181.35	Professional		$102.08	$128.40	$181.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.90 / $123.83 / $160.85	Professional		$115.90	$123.83	$160.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.63 / $173.79 / $173.79	Facility		$161.63	$173.79	$173.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.78 / $161.38 / $328.91	Professional		$105.78	$161.38	$328.91
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $314.33 / $426.38	Facility		$87.40	$314.33	$426.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $140.68 / $232.39	Professional		$103.56	$140.68	$232.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $141.00 / $318.62	Professional		$107.00	$141.00	$318.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $116.57 / $147.08 / $192.32	Professional		$116.57	$147.08	$192.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.97 / $122.93 / $204.89	Professional		$100.97	$122.93	$204.89
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $547.98 / $591.95 / $591.95	Facility		$547.98	$591.95	$591.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $786.09 / $794.81 / $1,068.00	Professional		$786.09	$794.81	$1,068.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Optum Facility/Professional Professional Modifier Low / Median / High Price $97.43 / $124.89 / $166.52	Professional		$97.43	$124.89	$166.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $118.68 / $148.61 / $190.34	Facility		$118.68	$148.61	$190.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $137.00 / $302.20	Professional		$107.00	$137.00	$302.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $97.43 / $125.76 / $209.30	Professional		$97.43	$125.76	$209.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $119.54 / $134.49 / $164.37	Professional		$119.54	$134.49	$164.37
United Facility/Professional Facility Modifier Low / Median / High Price $142.41 / $142.41 / $142.41	Facility		$142.41	$142.41	$142.41
United Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $143.91 / $461.94	Professional		$105.03	$143.91	$461.94