Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $812.83 / $977.24	Facility		$89.13	$812.83	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $724.44	Professional		$72.44	$97.72	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $87.10 / $380.19	Facility		$69.18	$87.10	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $213.80	Professional		$93.33	$97.72	$213.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $323.59 / $436.52	Facility		$97.72	$323.59	$436.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $354.81 / $602.56	Professional		$181.97	$354.81	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $117.49 / $117.49	Facility		$87.10	$117.49	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $117.49	Professional		$85.11	$85.11	$117.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $229.09	Professional		$100.00	$125.89	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $316.23	Professional		$114.82	$173.78	$316.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,258.93 / $1,258.93	Professional		$891.25	$1,258.93	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $162.18 / $229.09	Facility		$56.23	$162.18	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $154.88	Professional		$85.11	$85.11	$154.88
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $173.78	Professional		$100.00	$151.36	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $74.13 / $204.17	Facility		$12.30	$74.13	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $190.55	Professional		$69.18	$87.10	$190.55