Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $908.30 / $2,105.00	Facility		$66.00	$908.30	$2,105.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $607.29 / $1,121.93 / $3,586.00	Facility	25	$607.29	$1,121.93	$3,586.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $57.10 / $142.13	Professional		$32.78	$57.10	$142.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $76.56 / $200.47	Professional		$39.83	$76.56	$200.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,225.00 / $2,827.00 / $3,290.00	Facility		$1,225.00	$2,827.00	$3,290.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $58.05 / $103.05	Professional		$41.16	$58.05	$103.05
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $196.80 / $196.80 / $662.51	Facility		$196.80	$196.80	$662.51
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.33 / $45.50 / $107.66	Professional		$35.33	$45.50	$107.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.16 / $48.16 / $1,487.00	Facility		$48.16	$48.16	$1,487.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $51.74 / $140.26	Professional		$36.42	$51.74	$140.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.38 / $44.27 / $59.76	Professional		$24.38	$44.27	$59.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.84 / $53.59 / $154.00	Professional		$39.84	$53.59	$154.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $92.49 / $115.76 / $199.83	Facility		$92.49	$115.76	$199.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $500.00 / $500.00 / $500.00	Professional		$500.00	$500.00	$500.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $719.00	Professional		$32.34	$32.34	$719.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $46.22 / $246.32	Professional		$37.50	$46.22	$246.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.85 / $51.56 / $70.95	Facility		$36.85	$51.56	$70.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $59.07 / $111.41	Professional		$37.44	$59.07	$111.41
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $105.00 / $115.00	Facility		$105.00	$105.00	$115.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $46.33 / $246.32	Professional		$37.50	$46.33	$246.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $49.13 / $49.13	Professional		$35.72	$49.13	$49.13
United Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $44.39 / $104.80	Professional		$32.63	$44.39	$104.80