Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.84 / $195.50 / $715.04	Facility		$163.84	$195.50	$715.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.41 / $210.72 / $739.00	Professional		$152.41	$210.72	$739.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.13 / $987.71 / $1,187.70	Professional		$200.13	$987.71	$1,187.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.75 / $166.81 / $188.90	Facility		$143.75	$166.81	$188.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.18 / $217.77 / $449.09	Professional		$145.18	$217.77	$449.09
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $88.30 / $115.00 / $139.00	Facility		$88.30	$115.00	$139.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $294.07 / $635.63	Professional		$65.00	$294.07	$635.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $240.39 / $240.39 / $240.39	Facility		$240.39	$240.39	$240.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.63 / $261.76 / $514.91	Professional		$192.63	$261.76	$514.91
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $102.20 / $152.32	Professional		$81.76	$102.20	$152.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $638.07 / $939.00	Professional		$200.00	$638.07	$939.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $809.87 / $876.85 / $876.85	Facility		$809.87	$876.85	$876.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,155.58 / $1,355.26 / $1,355.26	Professional		$1,155.58	$1,355.26	$1,355.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $85.00 / $260.42	Professional		$60.00	$85.00	$260.42
Optum Facility/Professional Professional Modifier Low / Median / High Price $171.75 / $233.72 / $430.61	Professional		$171.75	$233.72	$430.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $177.15 / $240.56 / $341.00	Facility		$177.15	$240.56	$341.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $196.95 / $282.73 / $531.29	Professional		$196.95	$282.73	$531.29
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $195.00 / $261.00	Facility		$105.00	$195.00	$261.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $171.75 / $236.63 / $430.61	Professional		$171.75	$236.63	$430.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $153.30 / $220.52 / $267.50	Professional		$153.30	$220.52	$267.50
United Facility/Professional Professional Modifier Low / Median / High Price $171.99 / $229.82 / $529.48	Professional		$171.99	$229.82	$529.48