Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.66 / $171.57 / $465.10	Facility		$133.66	$171.57	$465.10
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $312.80 / $312.80 / $312.80	Facility	25	$312.80	$312.80	$312.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.18 / $164.15 / $545.00	Professional		$115.18	$164.15	$545.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $50.18 / $224.10 / $656.69	Professional	25	$50.18	$224.10	$656.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.22 / $179.03 / $235.20	Professional		$174.22	$179.03	$235.20
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $223.79 / $223.79 / $223.79	Professional	25	$223.79	$223.79	$223.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.84 / $182.37 / $480.30	Facility		$150.84	$182.37	$480.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.68 / $203.17 / $378.32	Professional		$140.68	$203.17	$378.32
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $166.07 / $378.90	Facility		$92.60	$166.07	$378.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.37 / $171.06 / $258.54	Professional		$125.37	$171.06	$258.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $199.44 / $381.30	Professional		$130.16	$199.44	$381.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $155.36 / $186.43 / $287.94	Professional		$155.36	$186.43	$287.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.26 / $186.99 / $325.97	Professional		$122.26	$186.99	$325.97
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $628.24 / $683.24 / $683.24	Facility		$628.24	$683.24	$683.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $887.76 / $887.76 / $1,291.38	Professional		$887.76	$887.76	$1,291.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $60.00	Professional		$32.34	$32.34	$60.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $119.99 / $171.59 / $268.55	Facility		$119.99	$171.59	$268.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.59 / $202.73 / $389.05	Professional		$134.59	$202.73	$389.05
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $321.75 / $321.75 / $488.37	Professional		$321.75	$321.75	$488.37
United Facility/Professional Professional Modifier Low / Median / High Price $144.31 / $200.83 / $517.84	Professional		$144.31	$200.83	$517.84