Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.42 / $159.00 / $5,278.78	Facility		$117.42	$159.00	$5,278.78
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $963.07 / $5,258.12 / $11,088.00	Facility	25	$963.07	$5,258.12	$11,088.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.56 / $160.10 / $460.94	Professional		$111.56	$160.10	$460.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.22 / $151.05 / $339.82	Professional		$118.22	$151.05	$339.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.50 / $156.57 / $412.35	Facility		$129.50	$156.57	$412.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $169.10 / $303.58	Professional		$129.19	$169.10	$303.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.80 / $326.57	Professional		$100.00	$138.80	$326.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.19 / $173.14 / $379.40	Professional		$123.19	$173.14	$379.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $109.09 / $193.48	Professional		$73.20	$109.09	$193.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.13 / $164.76 / $329.64	Professional		$120.13	$164.76	$329.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $282.95 / $587.34 / $634.03	Facility		$282.95	$587.34	$634.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $236.48 / $827.90 / $827.90	Professional		$236.48	$827.90	$827.90
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 $136.99 / $154.97 / $433.39	Professional		$136.99	$154.97	$433.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $125.40 / $159.00 / $227.37	Facility		$125.40	$159.00	$227.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $129.10 / $200.47 / $351.31	Professional		$129.10	$200.47	$351.31
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $143.52 / $143.52 / $143.52	Facility		$143.52	$143.52	$143.52
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $136.99 / $169.36 / $433.39	Professional		$136.99	$169.36	$433.39
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $90.91 / $127.28 / $159.16	Professional		$90.91	$127.28	$159.16
United Facility/Professional Professional Modifier Low / Median / High Price $105.03 / $143.93 / $387.38	Professional		$105.03	$143.93	$387.38