Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.00 / $2,370.91 / $6,584.00	Facility		$132.00	$2,370.91	$6,584.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,324.55 / $3,561.31 / $7,165.00	Facility	25	$1,324.55	$3,561.31	$7,165.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.28 / $132.00 / $403.06	Professional		$93.28	$132.00	$403.06
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.70 / $280.42 / $547.77	Professional	25	$97.70	$280.42	$547.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.22 / $332.31 / $495.76	Professional		$130.22	$332.31	$495.76
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.62 / $301.07 / $575.80	Professional	25	$114.62	$301.07	$575.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,225.00 / $2,827.00 / $13,163.00	Facility		$1,225.00	$2,827.00	$13,163.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.77 / $164.79 / $299.72	Professional		$112.77	$164.79	$299.72
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $498.06 / $498.06 / $3,141.80	Facility		$498.06	$498.06	$3,141.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.05 / $309.66	Professional		$100.00	$131.05	$309.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $4,051.00	Facility		$139.63	$139.63	$4,051.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.43 / $149.16 / $391.75	Professional		$106.43	$149.16	$391.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $126.77 / $171.14	Professional		$68.34	$126.77	$171.14
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $144.09 / $332.30 / $539.92	Professional		$144.09	$332.30	$539.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.09 / $153.91 / $346.00	Professional		$114.09	$153.91	$346.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $267.75 / $355.19 / $573.99	Facility		$267.75	$355.19	$573.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $748.12 / $748.12 / $748.12	Professional		$748.12	$748.12	$748.12
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 $108.28 / $130.90 / $246.32	Professional		$108.28	$130.90	$246.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $115.28 / $142.62 / $199.39	Facility		$115.28	$142.62	$199.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $110.37 / $167.15 / $319.87	Professional		$110.37	$167.15	$319.87
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 $108.28 / $133.44 / $304.83	Professional		$108.28	$133.44	$304.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $102.31 / $140.68 / $140.68	Professional		$102.31	$140.68	$140.68
United Facility/Professional Professional Modifier Low / Median / High Price $91.49 / $123.09 / $279.45	Professional		$91.49	$123.09	$279.45