Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.72 / $129.16 / $15,580.57	Facility		$62.72	$129.16	$15,580.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.72 / $147.78	Professional		$62.10	$62.72	$147.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $63.39 / $123.61	Professional		$62.10	$63.39	$123.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $99.19 / $222.36	Facility		$65.88	$99.19	$222.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $65.78 / $139.33	Professional		$62.10	$65.78	$139.33
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $73.59 / $86.30 / $121.99	Facility		$73.59	$86.30	$121.99
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $63.27 / $65.17 / $156.91	Professional		$63.27	$65.17	$156.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $58.58 / $62.10	Facility		$58.58	$58.58	$62.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $78.84	Professional		$62.10	$62.10	$78.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $67.45 / $86.24	Professional		$63.88	$67.45	$86.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.89 / $74.52 / $140.72	Professional		$55.89	$74.52	$140.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $84.71 / $310.50 / $314.95	Facility		$84.71	$310.50	$314.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $282.02 / $282.02 / $282.02	Professional		$282.02	$282.02	$282.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.95 / $130.95 / $130.95	Professional		$130.95	$130.95	$130.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $65.20 / $105.76	Facility		$62.10	$65.20	$105.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $87.87	Professional		$62.10	$62.10	$87.87
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $49.68 / $62.10 / $93.15	Professional		$49.68	$62.10	$93.15
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $65.67 / $124.68	Professional		$62.10	$65.67	$124.68