Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.29 / $38.90 / $120.04	Facility		$32.29	$38.90	$120.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.26 / $44.91 / $98.16	Professional		$29.26	$44.91	$98.16
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.71 / $55.52 / $67.55	Professional	25	$42.71	$55.52	$67.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $59.70 / $100.00	Professional		$56.25	$59.70	$100.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.76 / $71.05 / $187.12	Facility		$58.76	$71.05	$187.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.43 / $82.74 / $655.44	Professional		$47.43	$82.74	$655.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $192.78 / $256.70	Facility		$92.60	$192.78	$256.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $46.64 / $83.88	Professional		$39.90	$46.64	$83.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $48.62 / $102.68	Professional		$33.07	$48.62	$102.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $45.11 / $60.86 / $84.23	Professional		$45.11	$60.86	$84.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.11 / $58.59 / $104.14	Professional		$43.11	$58.59	$104.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $224.03 / $243.53 / $243.53	Facility		$224.03	$243.53	$243.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $316.30 / $316.30 / $394.41	Professional		$316.30	$316.30	$394.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.09 / $53.19 / $80.83	Facility		$33.09	$53.19	$80.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.60 / $52.22 / $110.40	Professional		$34.60	$52.22	$110.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $83.44 / $83.44 / $108.63	Professional		$83.44	$83.44	$108.63
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $63.15 / $81.39	Professional		$50.30	$63.15	$81.39
United Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $50.00 / $119.07	Professional		$33.78	$50.00	$119.07