Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.86 / $187.93 / $229.53	Facility		$164.86	$187.93	$229.53
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $817.91 / $17,391.36 / $18,642.96	Facility	25	$817.91	$17,391.36	$18,642.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.00 / $213.58 / $519.41	Professional		$159.00	$213.58	$519.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.82 / $180.62 / $503.46	Professional		$154.82	$180.62	$503.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.07 / $231.02 / $608.41	Facility		$191.07	$231.02	$608.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.87 / $249.51 / $444.84	Professional		$179.87	$249.51	$444.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $134.50 / $199.25 / $476.51	Professional		$134.50	$199.25	$476.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.79 / $254.11 / $557.32	Professional		$178.79	$254.11	$557.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $119.38 / $257.86	Professional		$80.09	$119.38	$257.86
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $177.90 / $177.90 / $286.50	Professional		$177.90	$177.90	$286.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.60 / $219.66 / $416.40	Professional		$157.60	$219.66	$416.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $378.19 / $782.64 / $845.03	Facility		$378.19	$782.64	$845.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $315.17 / $1,215.07 / $1,215.07	Professional		$315.17	$1,215.07	$1,215.07
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 $182.53 / $227.11 / $541.24	Professional		$182.53	$227.11	$541.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $163.59 / $216.96 / $328.23	Facility		$163.59	$216.96	$328.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.45 / $288.02 / $505.01	Professional		$181.45	$288.02	$505.01
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $182.53 / $227.30 / $541.24	Professional		$182.53	$227.30	$541.24
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $99.48 / $144.18 / $212.15	Professional		$99.48	$144.18	$212.15
United Facility/Professional Professional Modifier Low / Median / High Price $154.16 / $211.06 / $611.47	Professional		$154.16	$211.06	$611.47