Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $169.82 / $512.86	Facility		$131.83	$169.82	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $630.96	Professional		$123.03	$181.97	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $239.88	Professional		$134.90	$158.49	$239.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $144.54 / $158.49	Facility		$114.82	$144.54	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $323.59	Professional		$128.82	$199.53	$323.59
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 / $229.09 / $501.19	Professional		$45.71	$229.09	$501.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $204.17 / $354.81	Professional		$147.91	$204.17	$354.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $120.23	Professional		$64.57	$81.28	$120.23
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $398.11 / $776.25	Professional		$109.65	$398.11	$776.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $1,122.02 / $1,122.02	Professional		$208.93	$1,122.02	$1,122.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $112.20 / $229.09	Professional		$32.36	$112.20	$229.09
Optum Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $257.04	Professional		$151.36	$199.53	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $194.98 / $302.00	Facility		$134.90	$194.98	$302.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $213.80 / $398.11	Professional		$147.91	$213.80	$398.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $177.83	Professional		$81.28	$125.89	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $162.18 / $204.17	Facility		$100.00	$162.18	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $316.23	Professional		$123.03	$177.83	$316.23