Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $85.11 / $107.15	Facility		$75.86	$85.11	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $186.21	Professional		$72.44	$93.33	$186.21
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $162.18 / $162.18 / $316.23	Professional	25	$162.18	$162.18	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $107.15	Professional		$91.20	$91.20	$107.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $114.82 / $288.40	Facility		$91.20	$114.82	$288.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $251.19	Professional		$79.43	$123.03	$251.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $269.15	Professional		$83.18	$114.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $229.09	Professional		$83.18	$104.71	$229.09
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $125.89 / $151.36	Professional		$39.81	$125.89	$151.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $229.09	Professional		$93.33	$123.03	$229.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $616.60 / $616.60	Professional		$138.04	$616.60	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $154.88	Professional		$91.20	$91.20	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $138.04 / $173.78	Facility		$102.33	$138.04	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $245.47	Professional		$81.28	$112.20	$245.47
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $128.82	Professional		$52.48	$93.33	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $309.03	Professional		$74.13	$112.20	$309.03