Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.61 / $134.40 / $472.50	Facility		$22.61	$134.40	$472.50
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $35.19 / $157.50 / $515.25	Facility	CQ	$35.19	$157.50	$515.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $29.52 / $220.24	Professional		$14.40	$29.52	$220.24
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $25.39 / $25.39 / $25.39	Professional	CO	$25.39	$25.39	$25.39
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $23.17 / $39.27 / $80.53	Professional	CQ	$23.17	$39.27	$80.53
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 / $27.50 / $99.53	Professional		$4.34	$27.50	$99.53
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $43.83 / $80.36 / $133.88	Facility		$43.83	$80.36	$133.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $32.02 / $58.11	Professional		$23.38	$32.02	$58.11
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 $24.11 / $50.84 / $113.01	Professional		$24.11	$50.84	$113.01
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $11.74 / $15.50 / $49.71	Professional		$11.74	$15.50	$49.71
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $184.04 / $184.04 / $184.04	Professional		$184.04	$184.04	$184.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.27 / $35.79 / $62.32	Professional		$30.27	$35.79	$62.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $48.73 / $149.85 / $169.15	Facility		$48.73	$149.85	$169.15
Lucent Health Facility/Professional Facility Modifier CQ Low / Median / High Price $43.15 / $127.37 / $143.78	Facility	CQ	$43.15	$127.37	$143.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $39.21 / $216.50 / $268.95	Professional		$39.21	$216.50	$268.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.44 / $32.34 / $70.00	Professional		$13.44	$32.34	$70.00
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 $25.08 / $53.00 / $109.73	Professional		$25.08	$53.00	$109.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $116.59 / $116.59	Professional		$11.00	$116.59	$116.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $29.79 / $40.01	Professional		$15.50	$29.79	$40.01
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 $25.98 / $36.09 / $79.05	Professional		$25.98	$36.09	$79.05