Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $114.82 / $338.84	Facility		$83.18	$114.82	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $398.11	Professional		$77.62	$123.03	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $109.65 / $141.25	Professional		$83.18	$109.65	$141.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $89.13 / $100.00	Facility		$72.44	$89.13	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $213.80	Professional		$81.28	$134.90	$213.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $91.20	Facility		$83.18	$83.18	$91.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $165.96 / $346.74	Professional		$45.71	$165.96	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $239.88	Professional		$95.50	$138.04	$239.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $58.88 / $89.13	Professional		$47.86	$58.88	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $331.13 / $524.81	Professional		$97.72	$331.13	$524.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Professional		$741.31	$741.31	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $81.28 / $158.49	Professional		$32.36	$81.28	$158.49
Optum Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $213.80	Professional		$117.49	$147.91	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $134.90 / $204.17	Facility		$89.13	$134.90	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $144.54 / $257.04	Professional		$97.72	$144.54	$257.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $89.13 / $125.89	Professional		$58.88	$89.13	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $114.82 / $138.04	Facility		$64.57	$114.82	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $208.93	Professional		$79.43	$120.23	$208.93