Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.15 / $130.66 / $1,004.12	Facility		$105.15	$130.66	$1,004.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.92 / $136.24 / $350.61	Professional		$104.92	$136.24	$350.61
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $261.39 / $261.39 / $626.98	Professional	25	$261.39	$261.39	$626.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $142.83 / $148.38	Professional		$141.25	$142.83	$148.38
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $156.49 / $158.22 / $158.22	Professional	25	$156.49	$158.22	$158.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.68 / $180.65 / $203.85	Facility		$155.68	$180.65	$203.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $178.35 / $471.11	Professional		$113.17	$178.35	$471.11
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $152.75 / $216.51 / $362.63	Facility		$152.75	$216.51	$362.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $104.83 / $293.77	Professional		$77.98	$104.83	$293.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $145.66 / $195.24 / $263.57	Professional		$145.66	$195.24	$263.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.85 / $177.54 / $308.00	Professional		$129.85	$177.54	$308.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $245.20 / $653.54 / $653.54	Facility		$245.20	$653.54	$653.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $828.70 / $1,045.69 / $1,361.18	Professional		$828.70	$1,045.69	$1,361.18
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 $125.02 / $174.56 / $263.57	Facility		$125.02	$174.56	$263.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $405.46	Professional		$147.90	$147.90	$405.46
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $410.95 / $410.95 / $541.99	Professional		$410.95	$410.95	$541.99
United Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $159.12 / $396.95	Professional		$107.94	$159.12	$396.95