Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $154.88 / $501.19	Facility		$41.69	$154.88	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $436.52	Professional		$87.10	$158.49	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $177.83	Professional		$97.72	$123.03	$177.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $109.65 / $123.03	Facility		$89.13	$109.65	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $208.93	Professional		$89.13	$123.03	$208.93
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $91.20	Facility		$83.18	$83.18	$91.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $316.23	Professional		$125.89	$162.18	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $144.54 / $147.91	Facility		$97.72	$144.54	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $251.19	Professional		$91.20	$131.83	$251.19
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $131.83	Professional		$109.65	$109.65	$131.83
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $478.63 / $660.69	Professional		$151.36	$478.63	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $218.78	Professional		$81.28	$134.90	$218.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Facility		$588.84	$588.84	$588.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $776.25 / $776.25	Professional		$117.49	$776.25	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $123.03 / $204.17	Facility		$79.43	$123.03	$204.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $269.15	Professional		$91.20	$138.04	$269.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $177.83	Professional		$74.13	$109.65	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $208.93	Professional		$75.86	$109.65	$208.93