Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $159.34 / $496.00	Facility		$27.30	$159.34	$496.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.16 / $159.34 / $666.00	Professional		$138.16	$159.34	$666.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.50 / $217.50 / $217.50	Professional		$217.50	$217.50	$217.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.01 / $439.81 / $920.10	Facility		$121.01	$439.81	$920.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.86 / $155.36 / $276.17	Professional		$144.86	$155.36	$276.17
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $343.17 / $612.80	Facility		$97.00	$343.17	$612.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $384.60 / $895.87	Professional		$100.00	$384.60	$895.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.58 / $176.58 / $230.27	Facility		$176.58	$176.58	$230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.90 / $128.90 / $238.16	Professional		$128.90	$128.90	$238.16
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $154.94 / $185.94 / $318.85	Professional		$154.94	$185.94	$318.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.92 / $202.90 / $449.28	Professional		$173.92	$202.90	$449.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $498.89 / $1,382.94 / $1,382.94	Facility		$498.89	$1,382.94	$1,382.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,495.20 / $1,495.20 / $2,173.94	Professional		$1,495.20	$1,495.20	$2,173.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $896.60 / $896.60 / $896.60	Professional		$896.60	$896.60	$896.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $261.41 / $298.58	Facility		$85.45	$261.41	$298.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.90 / $176.58 / $264.80	Professional		$128.90	$176.58	$264.80
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $547.11 / $547.11 / $547.11	Professional		$547.11	$547.11	$547.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $154.94 / $231.89 / $232.43	Professional		$154.94	$231.89	$232.43
United Facility/Professional Professional Modifier Low / Median / High Price $122.38 / $132.35 / $292.45	Professional		$122.38	$132.35	$292.45