Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.68 / $3,380.00 / $10,952.00	Facility		$209.68	$3,380.00	$10,952.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,615.98 / $6,844.80 / $19,105.64	Facility	25	$1,615.98	$6,844.80	$19,105.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.63 / $243.66 / $845.43	Professional		$189.63	$243.66	$845.43
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $189.83 / $326.16 / $1,036.40	Professional	25	$189.83	$326.16	$1,036.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.89 / $262.94 / $821.02	Professional		$183.89	$262.94	$821.02
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $193.66 / $273.57 / $594.94	Professional	25	$193.66	$273.57	$594.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,245.00 / $2,827.00 / $7,018.00	Facility		$1,245.00	$2,827.00	$7,018.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.57 / $342.36 / $606.37	Professional		$248.57	$342.36	$606.37
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $95.10 / $2,985.56 / $5,047.37	Facility		$95.10	$2,985.56	$5,047.37
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $215.71 / $335.69 / $762.41	Professional		$215.71	$335.69	$762.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $286.33 / $5,063.00	Facility		$286.33	$286.33	$5,063.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.18 / $313.02 / $628.16	Professional		$217.18	$313.02	$628.16
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $121.60 / $252.87 / $377.75	Professional		$121.60	$252.87	$377.75
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $211.57 / $211.57 / $373.99	Professional		$211.57	$211.57	$373.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.81 / $289.70 / $535.14	Professional		$208.81	$289.70	$535.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $962.77 / $1,027.61 / $1,027.61	Facility		$962.77	$1,027.61	$1,027.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,336.39 / $1,733.52 / $1,733.52	Professional		$1,336.39	$1,733.52	$1,733.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $234.35	Professional		$32.34	$32.34	$234.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $200.38 / $277.79 / $421.55	Facility		$200.38	$277.79	$421.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $228.44 / $354.36 / $664.63	Professional		$228.44	$354.36	$664.63
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $572.26 / $572.26 / $728.22	Professional		$572.26	$572.26	$728.22
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $185.61 / $255.21 / $349.67	Professional		$185.61	$255.21	$349.67
United Facility/Professional Professional Modifier Low / Median / High Price $213.03 / $284.04 / $675.48	Professional		$213.03	$284.04	$675.48