Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.69 / $265.69 / $1,701.79	Facility		$265.69	$265.69	$1,701.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.95 / $265.69 / $531.38	Professional		$218.95	$265.69	$531.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.66 / $401.08 / $471.86	Professional		$309.66	$401.08	$471.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.81 / $831.17 / $1,872.27	Facility		$201.81	$831.17	$1,872.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.80 / $262.63 / $411.40	Professional		$215.80	$262.63	$411.40
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $698.30 / $1,246.96	Facility		$97.00	$698.30	$1,246.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $782.59 / $1,822.93	Professional		$100.00	$782.59	$1,822.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.68 / $345.03 / $345.03	Facility		$275.68	$345.03	$345.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.87 / $251.87 / $367.82	Professional		$251.87	$251.87	$367.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $206.53 / $247.84 / $648.79	Professional		$206.53	$247.84	$648.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $353.89 / $412.87 / $896.53	Professional		$353.89	$412.87	$896.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $953.40 / $2,801.65 / $2,801.65	Facility		$953.40	$2,801.65	$2,801.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,643.25 / $3,730.68 / $4,423.64	Professional		$3,643.25	$3,730.68	$4,423.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,407.91 / $1,407.91 / $1,407.91	Professional		$1,407.91	$1,407.91	$1,407.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $492.63 / $598.39	Facility		$142.47	$492.63	$598.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $251.87 / $345.03 / $501.35	Professional		$251.87	$345.03	$501.35
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,113.27 / $1,113.27 / $1,113.27	Professional		$1,113.27	$1,113.27	$1,113.27
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $206.53 / $351.10 / $471.86	Professional		$206.53	$351.10	$471.86
United Facility/Professional Professional Modifier Low / Median / High Price $200.39 / $220.69 / $547.20	Professional		$200.39	$220.69	$547.20