Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.95 / $309.76 / $540.36	Facility		$61.95	$309.76	$540.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.87 / $128.26 / $540.00	Professional		$122.87	$128.26	$540.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.31 / $172.64 / $186.64	Professional		$163.31	$172.64	$186.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.40 / $354.00 / $740.56	Facility		$97.40	$354.00	$740.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.05 / $116.61 / $222.32	Professional		$114.05	$116.61	$222.32
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $276.23 / $493.27	Facility		$97.00	$276.23	$493.27
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $309.55 / $721.07	Professional		$100.00	$309.55	$721.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.55 / $152.55 / $185.35	Facility		$152.55	$152.55	$185.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $111.36 / $162.62	Professional		$111.36	$111.36	$162.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $186.64 / $233.30 / $279.95	Professional		$186.64	$233.30	$279.95
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $398.90 / $398.90 / $398.90	Professional		$398.90	$398.90	$398.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $163.31 / $361.62	Professional		$139.97	$163.31	$361.62
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $401.60 / $1,113.14 / $1,113.14	Facility		$401.60	$1,113.14	$1,113.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,203.42 / $1,203.42 / $1,749.75	Professional		$1,203.42	$1,203.42	$1,749.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $492.63 / $492.63 / $492.63	Professional		$492.63	$492.63	$492.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.78 / $220.44 / $244.97	Facility		$68.78	$220.44	$244.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $152.55 / $222.06	Professional		$111.36	$152.55	$222.06
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $440.35 / $440.35 / $440.35	Professional		$440.35	$440.35	$440.35
United Facility/Professional Professional Modifier Low / Median / High Price $96.73 / $108.40 / $237.87	Professional		$96.73	$108.40	$237.87