Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $141.25 / $831.76	Facility		$91.20	$141.25	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $131.83 / $251.19	Professional		$75.86	$131.83	$251.19
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $89.13 / $144.54 / $218.78	Professional	25	$89.13	$144.54	$218.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	52	$123.03	$123.03	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $165.96	Professional		$104.71	$123.03	$165.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $120.23 / $151.36	Professional	25	$100.00	$120.23	$151.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $154.88 / $169.82	Facility		$125.89	$154.88	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $239.88	Professional		$107.15	$138.04	$239.88
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $186.21 / $371.54	Facility		$144.54	$186.21	$371.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $281.84	Professional		$112.20	$144.54	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $204.17	Facility		$95.50	$95.50	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $138.04	Professional		$117.49	$117.49	$138.04
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $186.21 / $229.09	Professional		$169.82	$186.21	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $263.03	Professional		$128.82	$151.36	$263.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $1,071.52 / $1,071.52	Professional		$173.78	$1,071.52	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $154.88 / $239.88	Facility		$102.33	$154.88	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $131.83	Professional		$109.65	$109.65	$131.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $229.09	Professional		$91.20	$125.89	$229.09