Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $123.03 / $154.88	Facility		$97.72	$123.03	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $407.38	Professional		$91.20	$141.25	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $120.23 / $302.00	Facility		$95.50	$120.23	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $316.23	Professional		$100.00	$154.88	$316.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $0.02 / $151.36 / $331.13	Professional		$0.02	$151.36	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $288.40	Professional		$104.71	$144.54	$288.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $56.23	Professional		$37.15	$46.77	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $398.11 / $457.09	Professional		$93.33	$398.11	$457.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Optum Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $407.38	Professional		$100.00	$131.83	$407.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $141.25 / $229.09	Facility		$104.71	$141.25	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $288.40	Professional		$107.15	$147.91	$288.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $104.71	Professional		$46.77	$64.57	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $316.23	Professional		$91.20	$123.03	$316.23