Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.28 / $231.39 / $611.74	Facility		$176.28	$231.39	$611.74
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $163.74 / $163.74 / $165.16	Facility	25	$163.74	$163.74	$165.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.72 / $242.96 / $611.74	Professional		$169.72	$242.96	$611.74
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $210.64 / $351.57 / $874.00	Professional	25	$210.64	$351.57	$874.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $185.52 / $257.58 / $261.89	Professional		$185.52	$257.58	$261.89
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $236.05 / $242.42 / $272.73	Professional	25	$236.05	$242.42	$272.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.73 / $268.08 / $706.05	Facility		$221.73	$268.08	$706.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.77 / $287.91 / $532.67	Professional		$197.77	$287.91	$532.67
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 $181.83 / $240.76 / $374.00	Professional		$181.83	$240.76	$374.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.22 / $277.36 / $520.49	Professional		$183.22	$277.36	$520.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $210.73 / $252.44 / $389.61	Professional		$210.73	$252.44	$389.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $253.86 / $440.43	Professional		$165.99	$253.86	$440.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $853.77 / $927.58 / $927.58	Facility		$853.77	$927.58	$927.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.95 / $1,202.95 / $1,741.13	Professional		$1,202.95	$1,202.95	$1,741.13
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 $172.27 / $236.33 / $363.64	Facility		$172.27	$236.33	$363.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $185.58 / $277.77 / $526.75	Professional		$185.58	$277.77	$526.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $423.60 / $423.60 / $644.47	Professional		$423.60	$423.60	$644.47
United Facility/Professional Professional Modifier Low / Median / High Price $192.36 / $274.80 / $886.10	Professional		$192.36	$274.80	$886.10