Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.74 / $140.59 / $497.76	Facility		$22.74	$140.59	$497.76
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $32.51 / $148.13 / $481.41	Facility	CO	$32.51	$148.13	$481.41
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $35.86 / $219.37 / $515.25	Facility	CQ	$35.86	$219.37	$515.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $32.97 / $206.21	Professional		$12.00	$32.97	$206.21
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $23.55 / $51.34 / $80.75	Professional	CO	$23.55	$51.34	$80.75
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $23.26 / $49.41 / $201.28	Professional	CQ	$23.26	$49.41	$201.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $25.60 / $66.91	Professional		$23.78	$25.60	$66.91
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $51.37 / $51.37 / $58.27	Professional	CQ	$51.37	$51.37	$58.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.83 / $92.65 / $385.82	Facility		$74.83	$92.65	$385.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.34 / $25.12 / $86.12	Professional		$4.34	$25.12	$86.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $41.37 / $77.00 / $129.25	Facility		$41.37	$77.00	$129.25
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $22.25 / $30.52 / $55.15	Professional		$22.25	$30.52	$55.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $85.00 / $315.00	Facility		$72.00	$85.00	$315.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $45.61 / $110.10	Professional		$22.12	$45.61	$110.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $13.90 / $44.65	Professional		$10.52	$13.90	$44.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.20 / $33.50 / $70.00	Professional		$27.20	$33.50	$70.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $43.76 / $134.74 / $152.00	Facility		$43.76	$134.74	$152.00
Lucent Health Facility/Professional Facility Modifier CO Low / Median / High Price $38.76 / $114.53 / $129.19	Facility	CO	$38.76	$114.53	$129.19
Lucent Health Facility/Professional Facility Modifier CQ Low / Median / High Price $38.76 / $114.53 / $129.19	Facility	CQ	$38.76	$114.53	$129.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $186.26 / $241.95	Professional		$35.22	$186.26	$241.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.05 / $41.41 / $95.00	Professional		$12.05	$41.41	$95.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $85.00 / $315.00	Facility		$72.00	$85.00	$315.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.24 / $48.21 / $108.10	Professional		$23.24	$48.21	$108.10
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $101.21 / $101.21	Professional		$11.00	$101.21	$101.21
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $13.90 / $26.73 / $35.90	Professional		$13.90	$26.73	$35.90
United Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $115.00 / $115.00	Facility		$115.00	$115.00	$115.00
United Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $31.40 / $68.54	Professional		$24.76	$31.40	$68.54