Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.90 / $149.90 / $992.70	Facility		$149.90	$149.90	$992.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.53 / $149.90 / $960.18	Professional		$123.53	$149.90	$960.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $249.59 / $249.59 / $249.59	Professional		$249.59	$249.59	$249.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.84 / $468.97 / $1,056.38	Facility		$113.84	$468.97	$1,056.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $150.94 / $266.83	Professional		$139.97	$150.94	$266.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $393.98 / $703.53	Facility		$97.00	$393.98	$703.53
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $441.55 / $1,028.52	Professional		$100.00	$441.55	$1,028.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $155.65 / $185.61 / $185.61	Facility		$155.65	$185.61	$185.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.50 / $135.50 / $197.87	Professional		$135.50	$135.50	$197.87
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $139.61 / $167.53 / $366.07	Professional		$139.61	$167.53	$366.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.67 / $232.95 / $515.82	Professional		$199.67	$232.95	$515.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $529.33 / $1,580.75 / $1,580.75	Facility		$529.33	$1,580.75	$1,580.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,673.42 / $1,713.56 / $2,495.92	Professional		$1,673.42	$1,713.56	$2,495.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $856.67 / $856.67 / $856.67	Professional		$856.67	$856.67	$856.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.38 / $285.27 / $332.79	Facility		$80.38	$285.27	$332.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $135.50 / $185.61 / $290.62	Professional		$135.50	$185.61	$290.62
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $628.13 / $628.13 / $628.13	Professional		$628.13	$628.13	$628.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $139.61 / $237.34 / $266.23	Professional		$139.61	$237.34	$266.23
United Facility/Professional Facility Modifier Low / Median / High Price $195.26 / $195.26 / $195.26	Facility		$195.26	$195.26	$195.26
United Facility/Professional Professional Modifier Low / Median / High Price $113.06 / $124.52 / $302.39	Professional		$113.06	$124.52	$302.39