Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.62 / $24.69 / $169.37	Facility		$22.62	$24.69	$169.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.60 / $26.91 / $106.00	Professional		$20.60	$26.91	$106.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.11 / $35.94 / $45.52	Professional		$26.11	$35.94	$45.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.03 / $614.00 / $876.00	Facility		$69.03	$614.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $69.97 / $121.12	Professional		$28.10	$69.97	$121.12
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $111.85 / $158.54 / $265.52	Facility		$111.85	$158.54	$265.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $22.40 / $31.35 / $78.51	Professional		$22.40	$31.35	$78.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.67 / $33.67 / $335.23	Facility		$33.67	$33.67	$335.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $24.70 / $24.70	Professional		$24.70	$24.70	$24.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.91 / $31.58 / $42.63	Professional		$27.91	$31.58	$42.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.82 / $31.99 / $57.00	Professional		$24.82	$31.99	$57.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $125.54 / $125.54	Facility		$50.00	$125.54	$125.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $161.03 / $178.40 / $225.60	Professional		$161.03	$178.40	$225.60
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 $24.67 / $32.79 / $58.57	Facility		$24.67	$32.79	$58.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $24.70 / $71.06	Professional		$24.70	$24.70	$71.06
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $87.17 / $87.17 / $94.39	Professional		$87.17	$87.17	$94.39
United Facility/Professional Professional Modifier Low / Median / High Price $22.41 / $29.95 / $68.31	Professional		$22.41	$29.95	$68.31