Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $1,862.09 / $3,162.28	Facility		$102.33	$1,862.09	$3,162.28
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $724.44 / $2,630.27 / $6,165.95	Facility	25	$724.44	$2,630.27	$6,165.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $229.09	Professional		$52.48	$74.13	$229.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $147.91 / $309.03	Professional	25	$66.07	$147.91	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $74.13 / $194.98	Professional		$64.57	$74.13	$194.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $60.26 / $79.43 / $194.98	Professional	25	$60.26	$79.43	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,089.30 / $6,606.93	Facility		$1,348.96	$2,089.30	$6,606.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $169.82	Professional		$69.18	$95.50	$169.82
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $102.33 / $204.17	Professional		$67.61	$102.33	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $1,174.90 / $2,137.96	Facility		$109.65	$1,174.90	$2,137.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $199.53	Professional		$60.26	$81.28	$199.53
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $74.13 / $100.00	Professional		$44.67	$74.13	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $239.88	Professional		$63.10	$85.11	$239.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $501.19 / $501.19	Professional		$112.20	$501.19	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $724.44	Professional		$104.71	$104.71	$724.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $245.47	Professional		$61.66	$75.86	$245.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $85.11 / $138.04	Facility		$66.07	$85.11	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $190.55	Professional		$60.26	$87.10	$190.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $67.61 / $83.18	Professional		$60.26	$67.61	$83.18
United Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Facility		$15.14	$15.14	$15.14
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $147.91	Professional		$51.29	$67.61	$147.91