Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.79 / $265.79 / $1,394.77	Facility		$265.79	$265.79	$1,394.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.46 / $265.79 / $389.70	Professional		$230.46	$265.79	$389.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $328.72 / $328.72 / $386.73	Professional		$328.72	$328.72	$386.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.83 / $733.55 / $1,534.49	Facility		$201.83	$733.55	$1,534.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.58 / $268.12 / $460.56	Professional		$241.58	$268.12	$460.56
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $572.29 / $1,021.95	Facility		$98.20	$572.29	$1,021.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $641.41 / $1,494.04	Professional		$100.00	$641.41	$1,494.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $312.81 / $312.81 / $384.02	Facility		$312.81	$312.81	$384.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.35 / $228.35 / $333.47	Professional		$228.35	$228.35	$333.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $258.38 / $310.06 / $531.75	Professional		$258.38	$310.06	$531.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $290.05 / $338.39 / $734.78	Professional		$290.05	$338.39	$734.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $778.08 / $2,306.87 / $2,306.87	Facility		$778.08	$2,306.87	$2,306.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,498.42 / $2,498.42 / $3,625.58	Professional		$2,498.42	$2,498.42	$3,625.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,020.73 / $1,020.73 / $1,020.73	Professional		$1,020.73	$1,020.73	$1,020.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $142.53 / $435.07 / $497.92	Facility		$142.53	$435.07	$497.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $228.35 / $312.81 / $460.12	Professional		$228.35	$312.81	$460.12
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $912.42 / $912.42 / $912.42	Professional		$912.42	$912.42	$912.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $258.38 / $386.73 / $387.57	Professional		$258.38	$386.73	$387.57
United Facility/Professional Professional Modifier Low / Median / High Price $200.46 / $220.78 / $489.25	Professional		$200.46	$220.78	$489.25