Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $281.54 / $1,124.10	Facility		$136.66	$281.54	$1,124.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $138.03 / $290.08	Professional		$136.66	$138.03	$290.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $136.22 / $136.22	Professional		$136.22	$136.22	$136.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.99 / $218.30 / $489.36	Facility		$144.99	$218.30	$489.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $141.37 / $299.45	Professional		$136.22	$141.37	$299.45
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.40 / $100.00 / $193.40	Facility		$77.40	$100.00	$193.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $139.24 / $139.24 / $317.68	Professional		$139.24	$139.24	$317.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.93 / $128.93 / $136.66	Facility		$128.93	$128.93	$136.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $159.53	Professional		$136.66	$136.66	$159.53
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $132.72 / $132.91 / $179.44	Professional		$132.72	$132.91	$179.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $164.00 / $286.00	Professional		$123.00	$164.00	$286.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $176.56 / $663.65 / $683.35	Facility		$176.56	$663.65	$683.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $586.87 / $586.87 / $586.87	Professional		$586.87	$586.87	$586.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $272.48 / $272.48 / $272.48	Professional		$272.48	$272.48	$272.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $142.13 / $232.99	Facility		$136.66	$142.13	$232.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $166.15	Professional		$136.66	$136.66	$166.15
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $197.07 / $197.07 / $197.07	Professional		$197.07	$197.07	$197.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $109.33 / $136.66 / $205.00	Professional		$109.33	$136.66	$205.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $136.66 / $241.76	Professional		$136.66	$136.66	$241.76