Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.85 / $110.56 / $135.80	Facility		$101.85	$110.56	$135.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.01 / $111.43 / $163.35	Professional		$92.01	$111.43	$163.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.77 / $115.47 / $141.93	Professional		$104.77	$115.47	$141.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.73 / $240.56 / $240.56	Facility		$223.73	$240.56	$240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $196.49 / $348.15	Professional		$96.00	$196.49	$348.15
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $253.60 / $350.60 / $902.60	Facility		$253.60	$350.60	$902.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $123.67 / $205.49	Professional		$93.94	$123.67	$205.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $122.00 / $185.62	Professional		$94.00	$122.00	$185.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $99.60 / $130.96 / $175.64	Professional		$99.60	$130.96	$175.64
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $319.48 / $383.01 / $383.01	Professional		$319.48	$383.01	$383.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.71 / $114.84 / $195.95	Professional		$90.71	$114.84	$195.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $496.55 / $531.86 / $531.86	Facility		$496.55	$531.86	$531.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $671.69 / $747.63 / $979.58	Professional		$671.69	$747.63	$979.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $173.68	Professional		$32.34	$32.34	$173.68
Optum Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $132.33 / $229.31	Professional		$111.78	$132.33	$229.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $131.12 / $167.70	Facility		$103.91	$131.12	$167.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $121.00 / $200.66	Professional		$95.00	$121.00	$200.66
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $142.00	Facility		$142.00	$142.00	$142.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $132.33 / $265.83	Professional		$111.78	$132.33	$265.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $108.22 / $122.84 / $150.13	Professional		$108.22	$122.84	$150.13
United Facility/Professional Facility Modifier Low / Median / High Price $137.82 / $137.82 / $137.82	Facility		$137.82	$137.82	$137.82
United Facility/Professional Professional Modifier Low / Median / High Price $97.09 / $132.33 / $388.56	Professional		$97.09	$132.33	$388.56