Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.87 / $113.71 / $421.29	Facility		$21.87	$113.71	$421.29
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $134.38 / $209.89 / $401.39	Facility	CO	$134.38	$209.89	$401.39
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $31.87 / $31.87 / $194.53	Facility	CQ	$31.87	$31.87	$194.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $24.91 / $274.48	Professional		$14.40	$24.91	$274.48
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $20.23 / $20.23 / $40.11	Professional	CQ	$20.23	$20.23	$40.11
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $24.92 / $24.92 / $24.92	Professional	CQ	$24.92	$24.92	$24.92
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 $4.88 / $26.56 / $96.71	Professional		$4.88	$26.56	$96.71
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $44.94 / $81.40 / $145.38	Facility		$44.94	$81.40	$145.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $33.14 / $59.09	Professional		$23.62	$33.14	$59.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $85.00 / $150.00	Facility		$72.00	$85.00	$150.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $49.48 / $113.16	Professional		$24.28	$49.48	$113.16
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $40.31 / $54.42	Professional		$40.31	$40.31	$54.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $36.00 / $68.48	Professional		$29.00	$36.00	$68.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $149.85 / $170.34	Facility		$80.00	$149.85	$170.34
Lucent Health Facility/Professional Facility Modifier CO Low / Median / High Price $43.41 / $127.37 / $144.79	Facility	CO	$43.41	$127.37	$144.79
Lucent Health Facility/Professional Facility Modifier CQ Low / Median / High Price $43.41 / $127.37 / $144.79	Facility	CQ	$43.41	$127.37	$144.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $207.96 / $270.23	Professional		$40.15	$207.96	$270.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.84 / $32.34 / $45.87	Professional		$5.84	$32.34	$45.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.16 / $37.17 / $50.94	Facility		$24.16	$37.17	$50.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.19 / $52.54 / $109.73	Professional		$25.19	$52.54	$109.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $113.23 / $113.23 / $113.23	Professional		$113.23	$113.23	$113.23
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $14.76 / $25.41 / $44.83	Professional		$14.76	$25.41	$44.83
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 $26.96 / $35.01 / $76.98	Professional		$26.96	$35.01	$76.98