Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.07 / $136.16 / $680.85	Facility		$86.07	$136.16	$680.85
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $810.00 / $810.00 / $4,779.87	Facility	25	$810.00	$810.00	$4,779.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.47 / $137.00 / $360.88	Professional		$76.47	$137.00	$360.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.01 / $134.09 / $176.21	Professional		$80.01	$134.09	$176.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.29 / $115.21 / $303.41	Facility		$95.29	$115.21	$303.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.51 / $120.57 / $218.15	Professional		$89.51	$120.57	$218.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $100.00 / $231.42	Professional		$78.66	$100.00	$231.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.50 / $126.12 / $280.37	Professional		$89.50	$126.12	$280.37
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $51.12 / $121.65	Professional		$34.29	$51.12	$121.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.80 / $103.84 / $214.76	Professional		$75.80	$103.84	$214.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $178.16 / $373.71 / $400.05	Facility		$178.16	$373.71	$400.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $613.55 / $613.55 / $613.55	Professional		$613.55	$613.55	$613.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $5,083.00	Professional		$32.34	$32.34	$5,083.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $87.53 / $113.65 / $433.39	Professional		$87.53	$113.65	$433.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $103.93 / $187.51	Facility		$76.20	$103.93	$187.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.23 / $142.47 / $253.38	Professional		$90.23	$142.47	$253.38
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $130.00 / $130.00	Facility		$130.00	$130.00	$130.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $87.53 / $115.34 / $433.39	Professional		$87.53	$115.34	$433.39
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.60 / $61.74 / $100.03	Professional		$42.60	$61.74	$100.03
United Facility/Professional Professional Modifier Low / Median / High Price $76.90 / $103.68 / $269.27	Professional		$76.90	$103.68	$269.27