Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.31 / $124.99 / $147.05	Facility		$100.31	$124.99	$147.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.01 / $124.40 / $182.67	Professional		$96.01	$124.40	$182.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $124.68 / $212.41	Professional		$101.72	$124.68	$212.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.34 / $235.84 / $235.84	Facility		$219.34	$235.84	$235.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.11 / $203.24 / $390.39	Professional		$102.11	$203.24	$390.39
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 $100.60 / $137.69 / $225.32	Professional		$100.60	$137.69	$225.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $134.00 / $204.42	Professional		$103.00	$134.00	$204.42
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $113.37 / $132.71 / $173.10	Professional		$113.37	$132.71	$173.10
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $331.21 / $331.21 / $331.21	Professional		$331.21	$331.21	$331.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.32 / $119.41 / $202.88	Professional		$92.32	$119.41	$202.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $481.38 / $515.85 / $515.85	Facility		$481.38	$515.85	$515.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $656.48 / $817.07 / $1,043.84	Professional		$656.48	$817.07	$1,043.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $184.44	Professional		$32.34	$32.34	$184.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $126.88 / $150.28 / $257.79	Professional		$126.88	$150.28	$257.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $101.44 / $137.72 / $182.74	Facility		$101.44	$137.72	$182.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $134.00 / $215.19	Professional		$104.00	$134.00	$215.19
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $129.00 / $129.00 / $177.00	Facility		$129.00	$129.00	$177.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $127.32 / $150.30 / $285.48	Professional		$127.32	$150.30	$285.48
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $104.92 / $128.24 / $163.47	Professional		$104.92	$128.24	$163.47
United Facility/Professional Facility Modifier Low / Median / High Price $147.38 / $147.38 / $147.38	Facility		$147.38	$147.38	$147.38
United Facility/Professional Professional Modifier Low / Median / High Price $109.15 / $149.65 / $360.98	Professional		$109.15	$149.65	$360.98