Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $161.94 / $501.83	Facility		$79.00	$161.94	$501.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.79 / $9,837.08	Professional		$79.00	$79.79	$9,837.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.25 / $90.25 / $90.25	Professional		$90.25	$90.25	$90.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.81 / $126.19 / $309.55	Facility		$83.81	$126.19	$309.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $81.42 / $166.74	Professional		$78.45	$81.42	$166.74
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $75.90 / $90.05 / $109.24	Facility		$75.90	$90.05	$109.24
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $84.51 / $179.84	Professional		$80.48	$84.51	$179.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $74.52 / $79.00	Facility		$74.52	$74.52	$79.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $96.88	Professional		$79.00	$79.00	$96.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $74.83 / $75.20 / $101.02	Professional		$74.83	$75.20	$101.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $94.80 / $173.80	Professional		$71.09	$94.80	$173.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.04 / $376.05 / $395.00	Facility		$100.04	$376.05	$395.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,210.38 / $6,210.38 / $6,210.38	Professional		$6,210.38	$6,210.38	$6,210.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $153.40 / $153.40	Professional		$60.00	$153.40	$153.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $82.16 / $134.40	Facility		$79.00	$82.16	$134.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $96.88	Professional		$79.00	$79.00	$96.88
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $113.45 / $113.45 / $113.45	Professional		$113.45	$113.45	$113.45
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $79.00 / $118.49	Professional		$63.20	$79.00	$118.49
United Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $139.66	Professional		$79.00	$79.00	$139.66