Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.04 / $4,848.00 / $16,125.00	Facility		$208.04	$4,848.00	$16,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.65 / $177.18 / $422.43	Professional		$64.65	$177.18	$422.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.53 / $169.53 / $250.87	Professional		$169.53	$169.53	$250.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,882.00 / $4,542.00 / $9,244.00	Facility		$1,882.00	$4,542.00	$9,244.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.97 / $164.43 / $313.52	Professional		$66.97	$164.43	$313.52
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $54.50 / $100.00 / $258.56	Facility		$54.50	$100.00	$258.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $71.58 / $138.07 / $263.25	Professional		$71.58	$138.07	$263.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.74 / $248.92 / $752.92	Facility		$210.74	$248.92	$752.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $157.99 / $334.31	Professional		$66.78	$157.99	$334.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $59.62 / $124.29 / $220.81	Professional		$59.62	$124.29	$220.81
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $142.77 / $142.77 / $142.77	Professional		$142.77	$142.77	$142.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.36 / $142.78 / $277.62	Professional		$51.36	$142.78	$277.62
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $257.30 / $257.30 / $257.30	Facility		$257.30	$257.30	$257.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $828.00 / $1,007.04 / $1,180.95	Professional		$828.00	$1,007.04	$1,180.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.45 / $134.82 / $257.89	Facility		$54.45	$134.82	$257.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $161.16 / $334.82	Professional		$66.78	$161.16	$334.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $217.45 / $217.45 / $545.64	Professional		$217.45	$217.45	$545.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $48.20 / $148.83 / $204.64	Professional		$48.20	$148.83	$204.64
United Facility/Professional Facility Modifier Low / Median / High Price $16.20 / $16.20 / $16.20	Facility		$16.20	$16.20	$16.20
United Facility/Professional Professional Modifier Low / Median / High Price $120.32 / $163.02 / $394.86	Professional		$120.32	$163.02	$394.86