Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.13 / $118.97 / $150.88	Facility		$82.13	$118.97	$150.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $111.27 / $185.57	Professional		$72.31	$111.27	$185.57
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $405.60 / $405.60 / $405.60	Professional	25	$405.60	$405.60	$405.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $115.26 / $115.26	Professional		$115.26	$115.26	$115.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.90 / $177.31 / $177.31	Facility		$164.90	$177.31	$177.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.49 / $163.18 / $375.25	Professional		$86.49	$163.18	$375.25
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $126.91 / $200.48	Professional		$82.95	$126.91	$200.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $152.91 / $374.54	Professional		$86.25	$152.91	$374.54
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $112.14 / $130.85 / $203.61	Professional		$112.14	$130.85	$203.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.32 / $124.93 / $199.44	Professional		$90.32	$124.93	$199.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $463.23 / $501.89 / $501.89	Facility		$463.23	$501.89	$501.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $635.76 / $635.76 / $920.04	Professional		$635.76	$635.76	$920.04
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 $79.53 / $130.60 / $180.80	Facility		$79.53	$130.60	$180.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.35 / $171.39 / $346.41	Professional		$95.35	$171.39	$346.41
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $207.74 / $207.74 / $328.83	Professional		$207.74	$207.74	$328.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $103.41 / $126.39 / $181.02	Professional		$103.41	$126.39	$181.02
United Facility/Professional Facility Modifier Low / Median / High Price $160.79 / $160.79 / $160.79	Facility		$160.79	$160.79	$160.79
United Facility/Professional Professional Modifier Low / Median / High Price $100.16 / $149.16 / $475.31	Professional		$100.16	$149.16	$475.31