Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $19.47 / $191.41	Facility		$17.78	$19.47	$191.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $28.99 / $185.24	Professional		$18.16	$28.99	$185.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.28 / $66.33 / $66.33	Professional		$52.28	$66.33	$66.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.45 / $36.67 / $96.96	Facility		$30.45	$36.67	$96.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.91 / $55.16 / $115.00	Professional		$29.91	$55.16	$115.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.87 / $91.80 / $140.25	Facility		$69.87	$91.80	$140.25
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.85 / $100.00 / $205.03	Professional		$35.85	$100.00	$205.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $39.86 / $52.70	Facility		$39.86	$39.86	$52.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $46.89	Professional		$33.88	$33.88	$46.89
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $66.33 / $79.59	Professional		$53.06	$66.33	$79.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $46.43 / $104.80	Professional		$39.79	$46.43	$104.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $134.65 / $315.07 / $315.07	Facility		$134.65	$315.07	$315.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $330.32 / $330.32 / $497.48	Professional		$330.32	$330.32	$497.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.19 / $199.19 / $199.19	Professional		$199.19	$199.19	$199.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $18.16 / $58.65 / $67.23	Facility		$18.16	$58.65	$67.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.86 / $60.53	Professional		$33.88	$39.86	$60.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $125.21 / $125.21 / $125.21	Professional		$125.21	$125.21	$125.21
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $125.64 / $306.93	Professional		$58.61	$125.64	$306.93
United Facility/Professional Professional Modifier Low / Median / High Price $25.26 / $28.13 / $66.34	Professional		$25.26	$28.13	$66.34