Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.45 / $86.34 / $107.01	Facility		$79.45	$86.34	$107.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $89.09 / $143.31	Professional		$71.53	$89.09	$143.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $97.00 / $152.85	Professional		$75.48	$97.00	$152.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.72 / $107.22 / $107.22	Facility		$99.72	$107.22	$107.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $104.33 / $195.84	Professional		$76.18	$104.33	$195.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.40 / $211.93 / $416.06	Facility		$87.40	$211.93	$416.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $106.40 / $171.26	Professional		$74.48	$106.40	$171.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,180.43 / $1,180.43 / $1,180.43	Facility		$1,180.43	$1,180.43	$1,180.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $98.00 / $164.90	Professional		$73.00	$98.00	$164.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.20 / $86.20 / $129.30	Professional		$56.20	$86.20	$129.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $84.39 / $141.51	Professional		$68.73	$84.39	$141.51
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $357.27 / $384.09 / $384.09	Facility		$357.27	$384.09	$384.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $507.82 / $590.30 / $737.78	Professional		$507.82	$590.30	$737.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $132.53 / $145.78	Professional		$32.34	$132.53	$145.78
Optum Facility/Professional Professional Modifier Low / Median / High Price $93.19 / $107.35 / $168.36	Professional		$93.19	$107.35	$168.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.70 / $102.07 / $134.30	Facility		$77.70	$102.07	$134.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $98.00 / $173.45	Professional		$75.00	$98.00	$173.45
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $95.00 / $177.00	Facility		$95.00	$95.00	$177.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $93.19 / $107.35 / $205.30	Professional		$93.19	$107.35	$205.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $78.38 / $94.26 / $115.20	Professional		$78.38	$94.26	$115.20
United Facility/Professional Facility Modifier Low / Median / High Price $105.66 / $105.66 / $105.66	Facility		$105.66	$105.66	$105.66
United Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $107.35 / $262.69	Professional		$78.00	$107.35	$262.69