Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.29 / $46.65 / $75.00	Facility		$34.29	$46.65	$75.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $61.19 / $142.94	Professional		$33.95	$61.19	$142.94
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.76 / $131.60 / $191.68	Professional	25	$41.76	$131.60	$191.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.89 / $65.22 / $98.25	Professional		$41.89	$65.22	$98.25
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $97.40 / $97.40 / $97.40	Professional	25	$97.40	$97.40	$97.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.11 / $46.09 / $121.40	Facility		$38.11	$46.09	$121.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.74 / $51.38 / $93.00	Professional		$39.74	$51.38	$93.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $44.14 / $100.00	Professional		$34.25	$44.14	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $53.51 / $108.32	Professional		$36.28	$53.51	$108.32
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.50 / $40.99 / $72.62	Professional		$27.50	$40.99	$72.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.69 / $60.68 / $111.88	Professional		$43.69	$60.68	$111.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $107.04 / $221.04 / $238.31	Facility		$107.04	$221.04	$238.31
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $10.70 / $22.10 / $23.83	Facility	AS	$10.70	$22.10	$23.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $350.74 / $368.28 / $368.28	Professional		$350.74	$368.28	$368.28
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 $43.96 / $50.88 / $261.64	Professional		$43.96	$50.88	$261.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.18 / $59.41 / $87.42	Facility		$42.18	$59.41	$87.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $62.33 / $122.01	Professional		$39.04	$62.33	$122.01
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $43.96 / $52.30 / $261.64	Professional		$43.96	$52.30	$261.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $47.82 / $59.74	Professional		$34.15	$47.82	$59.74
United Facility/Professional Professional Modifier Low / Median / High Price $31.08 / $42.18 / $119.40	Professional		$31.08	$42.18	$119.40