Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.77 / $15.31 / $114.69	Facility		$7.77	$15.31	$114.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $15.31 / $30.32	Professional		$7.76	$15.31	$30.32
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $21.33 / $22.54 / $86.20	Professional	25	$21.33	$22.54	$86.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.89 / $7.31 / $24.97	Professional	52	$3.89	$7.31	$24.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.48 / $15.54 / $19.42	Professional		$15.48	$15.54	$19.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.64 / $13.51 / $15.24	Facility		$11.64	$13.51	$15.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.49 / $21.28 / $41.66	Professional		$11.49	$21.28	$41.66
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.27 / $81.17 / $135.94	Facility		$57.27	$81.17	$135.94
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $9.41 / $18.28 / $36.99	Professional		$9.41	$18.28	$36.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.08 / $12.08 / $12.08	Facility		$12.08	$12.08	$12.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $15.77 / $15.77	Professional		$15.77	$15.77	$15.77
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $10.15 / $16.23 / $29.81	Professional		$10.15	$16.23	$29.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $9.02 / $18.21 / $33.01	Professional		$9.02	$18.21	$33.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Facility		$75.00	$75.00	$75.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $66.75 / $73.13 / $146.69	Professional		$66.75	$73.13	$146.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $32.34 / $32.34	Professional		$26.36	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $9.01 / $16.01 / $27.60	Facility		$9.01	$16.01	$27.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $15.77 / $44.00	Professional		$15.77	$15.77	$44.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $30.99 / $30.99 / $59.85	Professional		$30.99	$30.99	$59.85
United Facility/Professional Professional Modifier Low / Median / High Price $14.28 / $18.87 / $45.42	Professional		$14.28	$18.87	$45.42