Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.87 / $97.00 / $708.51	Facility		$91.87	$97.00	$708.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.19 / $136.85 / $320.00	Professional		$76.19	$136.85	$320.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $91.87 / $144.34 / $379.00	Professional	25	$91.87	$144.34	$379.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.56 / $118.53 / $143.63	Professional		$111.56	$118.53	$143.63
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $105.99 / $119.24 / $132.47	Professional	25	$105.99	$119.24	$132.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.63 / $144.62 / $163.19	Facility		$124.63	$144.62	$163.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.18 / $145.19 / $273.43	Professional		$107.18	$145.19	$273.43
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $137.91 / $139.44 / $232.38	Facility		$137.91	$139.44	$232.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $89.64 / $124.07 / $295.52	Professional		$89.64	$124.07	$295.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $146.59 / $146.59	Facility		$90.00	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $154.82 / $170.30 / $209.01	Professional		$154.82	$170.30	$209.01
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $154.81 / $154.81 / $154.81	Professional		$154.81	$154.81	$154.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.51 / $165.49 / $256.58	Professional		$125.51	$165.49	$256.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $223.36 / $667.49 / $667.49	Facility		$223.36	$667.49	$667.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $818.99 / $818.99 / $1,074.45	Professional		$818.99	$818.99	$1,074.45
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 $108.84 / $158.99 / $224.42	Facility		$108.84	$158.99	$224.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $132.11	Professional		$116.36	$116.36	$132.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $378.17 / $378.17 / $378.17	Professional		$378.17	$378.17	$378.17
United Facility/Professional Professional Modifier Low / Median / High Price $91.09 / $123.15 / $276.55	Professional		$91.09	$123.15	$276.55