Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $6,760.83 / $11,220.18	Facility		$346.74	$6,760.83	$11,220.18
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,621.81 / $7,413.10 / $11,220.18	Facility	25	$1,621.81	$7,413.10	$11,220.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $851.14	Professional		$190.55	$263.03	$851.14
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $331.13 / $1,000.00	Professional	25	$190.55	$331.13	$1,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $478.63	Professional		$173.78	$218.78	$478.63
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $218.78 / $562.34	Professional	25	$173.78	$218.78	$562.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $2,818.38 / $16,982.44	Facility		$263.03	$2,818.38	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $346.74 / $616.60	Professional		$251.19	$346.74	$616.60
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility		$1,071.52	$1,071.52	$1,071.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $812.83	Professional		$288.40	$416.87	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $3,890.45 / $5,128.61	Facility		$331.13	$3,890.45	$5,128.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $588.84	Professional		$218.78	$309.03	$588.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $218.78 / $446.68	Professional		$120.23	$218.78	$446.68
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $562.34	Professional		$194.98	$316.23	$562.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $1,737.80 / $1,737.80	Professional		$229.09	$1,737.80	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $389.05	Professional		$234.42	$234.42	$389.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $302.00 / $501.19	Facility		$199.53	$302.00	$501.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $616.60	Professional		$218.78	$323.59	$616.60
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $724.44	Professional		$575.44	$575.44	$724.44
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $338.84	Professional		$120.23	$199.53	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $489.78	Professional		$181.97	$263.03	$489.78