Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $407.38 / $812.83	Facility		$70.79	$407.38	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $194.98 / $741.31	Professional		$83.18	$194.98	$741.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $371.54	Professional		$112.20	$190.55	$371.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $102.33 / $199.53	Facility		$91.20	$102.33	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $165.96	Professional		$87.10	$102.33	$165.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $331.13	Professional		$120.23	$162.18	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $107.15	Professional		$97.72	$97.72	$107.15
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $489.78	Professional		$97.72	$125.89	$489.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $112.20 / $218.78	Facility		$87.10	$112.20	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $165.96	Professional		$97.72	$125.89	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $169.82	Professional		$85.11	$85.11	$169.82