Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $165.96 / $257.04	Professional		$131.83	$165.96	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $162.18 / $190.55	Professional		$147.91	$162.18	$190.55
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $173.78 / $173.78	Professional	25	$173.78	$173.78	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $199.53 / $398.11	Professional		$173.78	$199.53	$398.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $218.78	Professional		$131.83	$181.97	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $302.00	Professional		$147.91	$177.83	$302.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $223.87	Professional		$79.43	$100.00	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $281.84	Professional		$158.49	$204.17	$281.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $190.55 / $257.04	Facility		$114.82	$190.55	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $239.88	Professional		$147.91	$177.83	$239.88
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $251.19	Professional		$79.43	$100.00	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $181.97	Facility		$102.33	$102.33	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $478.63	Professional		$138.04	$169.82	$478.63