Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $393.16 / $948.00	Facility		$99.25	$393.16	$948.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.76 / $133.96 / $760.00	Professional		$103.76	$133.96	$760.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.50 / $252.23 / $690.00	Professional		$87.50	$252.23	$690.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.28 / $115.52 / $130.88	Facility		$108.28	$115.52	$130.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $108.89 / $212.33	Professional		$75.00	$108.89	$212.33
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $87.50 / $102.00 / $122.00	Facility		$87.50	$102.00	$122.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $121.70 / $296.67	Professional		$100.00	$121.70	$296.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Facility		$109.99	$109.99	$109.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Professional		$109.99	$109.99	$109.99
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $97.36 / $97.36 / $116.83	Professional		$97.36	$97.36	$116.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $343.00 / $393.93	Professional		$173.00	$343.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $231.98 / $638.99 / $662.25	Facility		$231.98	$638.99	$662.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $739.96 / $739.96 / $1,021.13	Professional		$739.96	$739.96	$1,021.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $242.98	Professional		$85.00	$85.00	$242.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.32 / $109.99 / $211.65	Facility		$106.32	$109.99	$211.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Professional		$109.99	$109.99	$109.99
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $97.36 / $107.10 / $165.51	Professional		$97.36	$107.10	$165.51
United Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $872.86	Professional		$450.58	$450.58	$872.86