Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.37 / $1,425.50 / $3,037.38	Facility		$69.37	$1,425.50	$3,037.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $721.73 / $2,262.84 / $4,402.09	Facility	25	$721.73	$2,262.84	$4,402.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.95 / $69.37 / $215.55	Professional		$52.95	$69.37	$215.55
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $70.06 / $212.09 / $325.22	Professional	25	$70.06	$212.09	$325.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.05 / $191.54 / $264.14	Professional		$68.05	$191.54	$264.14
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.29 / $201.46 / $338.42	Professional	25	$67.29	$201.46	$338.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,225.00 / $2,827.00 / $6,581.00	Facility		$1,225.00	$2,827.00	$6,581.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.15 / $90.07 / $161.99	Professional		$69.15	$90.07	$161.99
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $309.68 / $309.68 / $1,564.07	Facility		$309.68	$309.68	$1,564.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.74 / $77.39 / $180.45	Professional		$60.74	$77.39	$180.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $82.02 / $2,116.00	Facility		$82.02	$82.02	$2,116.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.49 / $83.71 / $219.79	Professional		$59.49	$83.71	$219.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $44.60 / $74.68 / $100.82	Professional		$44.60	$74.68	$100.82
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $288.54 / $288.54 / $288.54	Professional		$288.54	$288.54	$288.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $90.35 / $242.00	Professional		$67.20	$90.35	$242.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $157.05 / $206.93 / $337.35	Facility		$157.05	$206.93	$337.35
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 $64.13 / $76.40 / $246.32	Professional		$64.13	$76.40	$246.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.41 / $84.69 / $117.18	Facility		$67.41	$84.69	$117.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $94.93 / $189.58	Professional		$61.30	$94.93	$189.58
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $165.00 / $182.00	Facility		$165.00	$165.00	$182.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $64.13 / $77.58 / $246.32	Professional		$64.13	$77.58	$246.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $82.89 / $82.89	Professional		$60.28	$82.89	$82.89
United Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $67.69 / $153.28	Professional		$50.53	$67.69	$153.28