Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $1,621.81	Facility		$204.17	$204.17	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $389.05 / $933.25	Professional		$194.98	$389.05	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $275.42 / $295.12	Professional		$257.04	$275.42	$295.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $194.98 / $831.76	Facility		$154.88	$194.98	$831.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $457.09	Professional		$223.87	$223.87	$457.09
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $645.65 / $870.96	Facility		$100.00	$645.65	$870.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $691.83 / $1,202.26	Professional		$354.81	$691.83	$1,202.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $208.93	Professional		$154.88	$154.88	$208.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $281.84 / $457.09	Professional		$229.09	$281.84	$457.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $616.60	Professional		$208.93	$338.84	$616.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,754.23 / $2,754.23	Professional		$1,905.46	$2,754.23	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $346.74 / $467.74	Facility		$114.82	$346.74	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $363.08	Professional		$154.88	$154.88	$363.08
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $302.00 / $389.05	Professional		$229.09	$302.00	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $165.96 / $457.09	Facility		$27.54	$165.96	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $371.54	Professional		$154.88	$186.21	$371.54