Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $415.60	Facility		$75.00	$75.00	$415.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.68 / $75.00 / $415.60	Professional		$62.68	$75.00	$415.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.01 / $89.01 / $89.01	Professional		$89.01	$89.01	$89.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.75 / $187.25 / $457.23	Facility		$33.75	$187.25	$457.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $45.00 / $137.22	Professional		$40.00	$45.00	$137.22
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $80.50 / $100.00 / $337.75	Facility		$80.50	$100.00	$337.75
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $191.12 / $445.19	Professional		$77.84	$191.12	$445.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.71 / $83.71 / $114.43	Facility		$83.71	$83.71	$114.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $61.11 / $89.24	Professional		$61.11	$61.11	$89.24
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $115.23 / $144.04 / $172.85	Professional		$115.23	$144.04	$172.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.42 / $100.83 / $223.26	Professional		$86.42	$100.83	$223.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $247.90 / $688.05 / $688.05	Facility		$247.90	$688.05	$688.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $743.07 / $743.07 / $1,080.30	Professional		$743.07	$743.07	$1,080.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $304.09 / $304.09 / $304.09	Professional		$304.09	$304.09	$304.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $144.04 / $154.94	Facility		$75.00	$144.04	$154.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $83.71 / $141.19	Professional		$61.11	$83.71	$141.19
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $271.87 / $271.87 / $271.87	Professional		$271.87	$271.87	$271.87
United Facility/Professional Facility Modifier Low / Median / High Price $10.89 / $65.33 / $67.22	Facility		$10.89	$65.33	$67.22
United Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $67.22 / $151.86	Professional		$62.05	$67.22	$151.86