Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.37 / $153.37 / $772.14	Facility		$153.37	$153.37	$772.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.45 / $153.37 / $581.00	Professional		$105.45	$153.37	$581.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $179.31 / $205.64	Professional		$155.75	$179.31	$205.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $176.37 / $427.47 / $948.28	Facility		$176.37	$427.47	$948.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.75 / $157.10 / $255.00	Professional		$128.75	$157.10	$255.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $327.39 / $584.65	Facility		$97.00	$327.39	$584.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $355.09 / $827.13	Professional		$100.00	$355.09	$827.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $212.60	Facility		$142.00	$142.00	$212.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $103.66 / $151.38	Professional		$103.66	$103.66	$151.38
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $167.56 / $201.07 / $294.38	Professional		$167.56	$201.07	$294.38
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $160.57 / $198.00	Professional		$128.69	$160.57	$198.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.57 / $187.33 / $414.81	Professional		$160.57	$187.33	$414.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $460.64 / $1,281.52 / $1,281.52	Facility		$460.64	$1,281.52	$1,281.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.26 / $1,380.26 / $2,007.15	Professional		$1,380.26	$1,380.26	$2,007.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $275.66 / $275.66 / $565.10	Professional		$275.66	$275.66	$565.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $153.37 / $267.62 / $281.00	Facility		$153.37	$267.62	$281.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $142.00 / $254.73	Professional		$103.66	$142.00	$254.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $505.12 / $505.12 / $505.12	Professional		$505.12	$505.12	$505.12
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $167.56 / $214.10 / $240.86	Professional		$167.56	$214.10	$240.86
United Facility/Professional Professional Modifier Low / Median / High Price $115.03 / $132.32 / $337.25	Professional		$115.03	$132.32	$337.25