Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.15 / $266.30 / $1,656.39	Facility		$81.15	$266.30	$1,656.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $266.30 / $292.93	Professional		$141.60	$266.30	$292.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $77.50 / $77.50	Professional		$77.50	$77.50	$77.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.44 / $296.77 / $385.01	Facility		$245.44	$296.77	$385.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.00 / $272.70 / $526.16	Professional		$224.00	$272.70	$526.16
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $68.31 / $75.91 / $185.05	Professional		$68.31	$75.91	$185.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Facility		$272.70	$272.70	$272.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Professional		$272.70	$272.70	$272.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.56 / $42.56 / $51.07	Professional		$42.56	$42.56	$51.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.00 / $316.00 / $471.00	Professional		$208.00	$316.00	$471.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $385.01 / $641.67 / $1,203.15	Facility		$385.01	$641.67	$1,203.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,219.19 / $1,219.19 / $1,443.78	Professional		$1,219.19	$1,219.19	$1,443.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.91 / $71.91 / $85.00	Professional		$71.91	$71.91	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $232.45 / $279.62 / $381.00	Facility		$232.45	$279.62	$381.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $272.70 / $304.80	Professional		$272.70	$272.70	$304.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.56 / $46.82 / $72.34	Professional		$42.56	$46.82	$72.34
United Facility/Professional Professional Modifier Low / Median / High Price $267.37 / $267.37 / $584.92	Professional		$267.37	$267.37	$584.92