Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.34 / $158.24 / $476.25	Facility		$80.34	$158.24	$476.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $80.34 / $261.00 / $545.00	Facility	25	$80.34	$261.00	$545.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.12 / $136.35 / $364.00	Professional		$68.12	$136.35	$364.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.97 / $141.93 / $386.00	Professional	25	$66.97	$141.93	$386.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.11 / $130.69 / $249.85	Professional		$90.11	$130.69	$249.85
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $104.75 / $130.69 / $270.56	Professional	25	$104.75	$130.69	$270.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.15 / $83.72 / $94.81	Facility		$72.15	$83.72	$94.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.16 / $109.85 / $189.73	Professional		$75.16	$109.85	$189.73
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $88.30 / $115.00 / $139.00	Facility		$88.30	$115.00	$139.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $82.36 / $117.65 / $274.22	Professional		$82.36	$117.65	$274.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $150.00 / $180.00	Facility		$125.00	$150.00	$180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $123.56 / $260.79	Professional		$76.25	$123.56	$260.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $107.83 / $182.82	Professional		$37.50	$107.83	$182.82
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $176.80 / $388.00	Professional		$120.00	$176.80	$388.00
HealthNet Facility/Professional Professional Modifier 25 Low / Median / High Price $90.73 / $195.00 / $515.00	Professional	25	$90.73	$195.00	$515.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $140.18 / $250.00	Professional		$96.65	$140.18	$250.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $260.00 / $475.57 / $475.57	Facility		$260.00	$475.57	$475.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $226.33 / $607.94 / $801.06	Professional		$226.33	$607.94	$801.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $182.19	Professional		$32.34	$32.34	$182.19
Optum Facility/Professional Professional Modifier Low / Median / High Price $109.17 / $133.99 / $297.16	Professional		$109.17	$133.99	$297.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.66 / $120.16 / $189.98	Facility		$67.66	$120.16	$189.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.04 / $133.80 / $285.27	Professional		$77.04	$133.80	$285.27
Providence Facility/Professional Professional Modifier 25 Low / Median / High Price $47.00 / $47.00 / $47.00	Professional	25	$47.00	$47.00	$47.00
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $104.00 / $119.00 / $241.00	Facility		$104.00	$119.00	$241.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $137.41 / $294.29	Professional		$110.00	$137.41	$294.29
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $119.77 / $169.29	Professional		$56.25	$119.77	$169.29
United Facility/Professional Facility Modifier Low / Median / High Price $147.38 / $147.38 / $147.38	Facility		$147.38	$147.38	$147.38
United Facility/Professional Professional Modifier Low / Median / High Price $81.54 / $110.43 / $258.63	Professional		$81.54	$110.43	$258.63