Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.80 / $322.68 / $630.78	Facility		$74.80	$322.68	$630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $75.73 / $326.00	Professional		$57.11	$75.73	$326.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $119.16 / $119.16 / $119.16	Professional	25	$119.16	$119.16	$119.16
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $57.12 / $57.12 / $57.12	Professional	CQ	$57.12	$57.12	$57.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.04 / $87.04 / $131.25	Professional		$87.04	$87.04	$131.25
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 $63.57 / $97.27 / $246.63	Professional		$63.57	$97.27	$246.63
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $147.61 / $263.58	Facility		$96.60	$147.61	$263.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $69.45 / $111.20	Professional		$49.01	$69.45	$111.20
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 $57.75 / $91.19 / $232.96	Professional		$57.75	$91.19	$232.96
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $70.04 / $121.33 / $151.66	Professional		$70.04	$121.33	$151.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $108.80 / $200.00	Professional		$81.59	$108.80	$200.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $145.60 / $376.05 / $516.79	Facility		$145.60	$376.05	$516.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $633.66 / $824.10	Professional		$128.13	$633.66	$824.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $70.00 / $141.72	Professional		$32.34	$70.00	$141.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.91 / $114.76 / $151.66	Facility		$62.91	$114.76	$151.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $95.46 / $232.96	Professional		$57.75	$95.46	$232.96
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $283.32 / $283.32 / $283.32	Professional		$283.32	$283.32	$283.32
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Facility		$300.00	$300.00	$300.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $87.70 / $200.84	Professional		$69.76	$87.70	$200.84