Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $107.15 / $398.11	Facility		$23.99	$107.15	$398.11
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $186.21 / $363.08 / $446.68	Facility	CO	$186.21	$363.08	$446.68
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $45.71 / $194.98 / $199.53	Facility	CQ	$45.71	$194.98	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $32.36 / $309.03	Professional		$15.14	$32.36	$309.03
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $27.54 / $27.54 / $27.54	Professional	CO	$27.54	$27.54	$27.54
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $20.42 / $39.81 / $81.28	Professional	CQ	$20.42	$39.81	$81.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $95.50 / $239.88	Facility		$77.62	$95.50	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $50.12 / $109.65	Professional		$23.99	$50.12	$109.65
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $85.11 / $151.36	Facility		$44.67	$85.11	$151.36
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $91.20	Professional		$30.20	$39.81	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $85.11 / $151.36	Facility		$72.44	$85.11	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $36.31 / $74.13	Professional		$23.44	$36.31	$74.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $44.67 / $54.95	Professional		$40.74	$44.67	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $36.31 / $63.10	Professional		$28.84	$36.31	$63.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $208.93 / $208.93	Facility		$44.67	$208.93	$208.93
Lucent Health Facility/Professional Facility Modifier CO Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	CO	$177.83	$177.83	$177.83
Lucent Health Facility/Professional Facility Modifier CQ Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	CQ	$177.83	$177.83	$177.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $269.15	Professional		$37.15	$44.67	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $32.36 / $45.71	Professional		$5.89	$32.36	$45.71
Optum Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $39.81	Professional		$30.90	$30.90	$39.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $36.31 / $54.95	Facility		$23.44	$36.31	$54.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $37.15 / $81.28	Professional		$22.91	$37.15	$81.28
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $21.38 / $37.15	Professional		$10.23	$21.38	$37.15
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $34.67 / $69.18	Professional		$26.30	$34.67	$69.18