Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.81 / $33.19 / $241.48	Facility		$22.81	$33.19	$241.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $38.86 / $94.02	Professional		$23.91	$38.86	$94.02
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.27 / $60.00 / $172.00	Professional	25	$41.27	$60.00	$172.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.28 / $15.61 / $54.60	Professional	52	$11.28	$15.61	$54.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $37.84 / $41.50	Professional		$33.60	$37.84	$41.50
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $15.93 / $33.60 / $35.54	Professional	25	$15.93	$33.60	$35.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.85 / $45.08 / $50.87	Facility		$38.85	$45.08	$50.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $46.77 / $90.90	Professional		$33.90	$46.77	$90.90
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $86.38 / $122.44 / $205.06	Facility		$86.38	$122.44	$205.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $26.18 / $40.58 / $93.11	Professional		$26.18	$40.58	$93.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $35.77 / $35.77	Facility		$35.77	$35.77	$35.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $46.99 / $63.44	Professional		$30.47	$46.99	$63.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $41.70 / $72.14	Professional		$27.10	$41.70	$72.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $65.65 / $140.72 / $140.72	Facility		$65.65	$140.72	$140.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $171.97 / $245.75 / $327.08	Professional		$171.97	$245.75	$327.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.84 / $39.42 / $62.63	Facility		$26.84	$39.42	$62.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $97.18	Professional		$34.82	$34.82	$97.18
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $90.67 / $129.13	Professional		$90.67	$90.67	$129.13
United Facility/Professional Professional Modifier Low / Median / High Price $29.69 / $40.09 / $94.54	Professional		$29.69	$40.09	$94.54