Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.03 / $360.50 / $4,508.60	Facility		$93.03	$360.50	$4,508.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.66 / $93.03 / $106.98	Professional		$89.66	$93.03	$106.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $86.00 / $86.00	Professional		$86.00	$86.00	$86.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.74 / $107.79 / $144.00	Facility		$85.74	$107.79	$144.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $100.00 / $191.66	Professional		$95.27	$100.00	$191.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $90.39 / $220.34	Professional		$81.34	$90.39	$220.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $95.27 / $95.27	Facility		$95.27	$95.27	$95.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $95.27 / $95.27	Professional		$95.27	$95.27	$95.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $51.80 / $51.80 / $62.16	Professional		$51.80	$51.80	$62.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $199.00 / $393.93	Professional		$131.00	$199.00	$393.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $134.50 / $224.16 / $420.30	Facility		$134.50	$224.16	$420.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $425.90 / $425.90 / $504.36	Professional		$425.90	$425.90	$504.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $155.80	Professional		$85.00	$85.00	$155.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $112.08 / $133.25	Facility		$95.27	$112.08	$133.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $95.27 / $112.08	Professional		$95.27	$95.27	$112.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $51.80 / $56.98 / $88.06	Professional		$51.80	$56.98	$88.06
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $197.40	Professional		$100.00	$100.00	$197.40