Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.38 / $143.60 / $1,033.65	Facility		$136.38	$143.60	$1,033.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.53 / $176.17 / $556.84	Professional		$115.53	$176.17	$556.84
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $256.83 / $677.00	Professional	25	$115.53	$256.83	$677.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.94 / $159.30 / $174.17	Professional		$140.94	$159.30	$174.17
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $142.53 / $142.53 / $167.36	Professional	25	$142.53	$142.53	$167.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.02 / $214.70 / $242.27	Facility		$185.02	$214.70	$242.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.04 / $208.37 / $403.10	Professional		$143.04	$208.37	$403.10
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $174.17 / $176.17 / $341.85	Facility		$174.17	$176.17	$341.85
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $125.62 / $183.34 / $434.56	Professional		$125.62	$183.34	$434.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $187.13 / $187.13	Facility		$90.00	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $194.78 / $214.26 / $262.95	Professional		$194.78	$214.26	$262.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.55 / $211.40 / $336.48	Professional		$158.55	$211.40	$336.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $285.58 / $842.92 / $842.92	Facility		$285.58	$842.92	$842.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,045.69 / $1,045.69 / $1,358.33	Professional		$1,045.69	$1,045.69	$1,358.33
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 $149.69 / $201.22 / $283.33	Facility		$149.69	$201.22	$283.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $194.71	Professional		$147.60	$147.60	$194.71
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $556.41 / $556.41 / $556.41	Professional		$556.41	$556.41	$556.41
United Facility/Professional Professional Modifier Low / Median / High Price $133.11 / $177.23 / $405.51	Professional		$133.11	$177.23	$405.51