Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $3,090.30 / $6,606.93	Facility		$363.08	$3,090.30	$6,606.93
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,479.11 / $4,365.16 / $7,585.78	Facility	25	$1,479.11	$4,365.16	$7,585.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $436.52	Professional		$93.33	$134.90	$436.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.72 / $218.78 / $489.78	Professional	25	$97.72	$218.78	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $323.59	Professional		$109.65	$158.49	$323.59
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $128.82 / $331.13	Professional	25	$100.00	$128.82	$331.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,089.30 / $13,182.57	Facility		$1,348.96	$2,089.30	$13,182.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $302.00	Professional		$112.20	$165.96	$302.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $346.74	Professional		$114.82	$173.78	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $2,511.89 / $4,168.69	Facility		$186.21	$2,511.89	$4,168.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $338.84	Professional		$107.15	$147.91	$338.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $169.82	Professional		$67.61	$125.89	$169.82
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $416.87 / $478.63	Professional		$144.54	$416.87	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $346.74	Professional		$107.15	$144.54	$346.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $741.31 / $741.31	Professional		$125.89	$741.31	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $724.44	Professional		$177.83	$177.83	$724.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $245.47	Professional		$107.15	$144.54	$245.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $147.91 / $239.88	Facility		$117.49	$147.91	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $316.23	Professional		$107.15	$154.88	$316.23
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $141.25	Professional		$102.33	$102.33	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $251.19	Professional		$93.33	$123.03	$251.19