Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.43 / $177.70 / $10,283.00	Facility		$96.43	$177.70	$10,283.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $324.39 / $870.60 / $2,244.06	Facility	25	$324.39	$870.60	$2,244.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $115.39 / $553.49	Professional		$90.95	$115.39	$553.49
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $105.70 / $362.70 / $1,305.58	Professional	25	$105.70	$362.70	$1,305.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.67 / $108.33 / $172.43	Professional		$86.67	$108.33	$172.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $86.66 / $119.16 / $297.91	Professional	25	$86.66	$119.16	$297.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.69 / $151.69 / $171.78	Facility		$151.69	$151.69	$171.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.30 / $159.00 / $269.04	Professional		$112.30	$159.00	$269.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $149.41 / $336.26	Professional		$100.00	$149.41	$336.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.15 / $143.15 / $5,063.00	Facility		$143.15	$143.15	$5,063.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.03 / $145.29 / $293.36	Professional		$106.03	$145.29	$293.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $58.90 / $126.78 / $166.45	Professional		$58.90	$126.78	$166.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.97 / $136.90 / $243.75	Professional		$103.97	$136.90	$243.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $481.38 / $514.57 / $514.57	Facility		$481.38	$514.57	$514.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $671.20 / $1,183.50 / $1,183.50	Professional		$671.20	$1,183.50	$1,183.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $103.69	Professional		$32.34	$32.34	$103.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.53 / $134.43 / $186.96	Facility		$100.53	$134.43	$186.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.43 / $163.98 / $300.82	Professional		$111.43	$163.98	$300.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $287.62 / $287.62 / $319.58	Professional		$287.62	$287.62	$319.58
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $93.06 / $120.99 / $147.87	Professional		$93.06	$120.99	$147.87
United Facility/Professional Professional Modifier Low / Median / High Price $94.04 / $125.64 / $286.68	Professional		$94.04	$125.64	$286.68
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $90.00 / $255.60	Professional	25	$80.00	$90.00	$255.60