Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.70 / $204.70 / $1,311.10	Facility		$204.70	$204.70	$1,311.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.50 / $204.70 / $423.29	Professional		$177.50	$204.70	$423.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.49 / $243.49 / $272.64	Professional		$204.49	$243.49	$272.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.44 / $640.35 / $1,442.43	Facility		$155.44	$640.35	$1,442.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.00 / $206.94 / $394.52	Professional		$206.00	$206.94	$394.52
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $537.98 / $960.68	Facility		$98.20	$537.98	$960.68
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $602.92 / $1,404.42	Professional		$100.00	$602.92	$1,404.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $212.39 / $229.50 / $243.27	Facility		$212.39	$229.50	$243.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $167.54 / $244.66	Professional		$167.54	$167.54	$244.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $242.90 / $291.48 / $499.85	Professional		$242.90	$291.48	$499.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $272.64 / $318.08 / $690.70	Professional		$272.64	$318.08	$690.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $712.67 / $1,920.53 / $2,158.44	Facility		$712.67	$1,920.53	$2,158.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,381.81 / $2,438.96 / $2,922.75	Professional		$2,381.81	$2,438.96	$2,922.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $831.93 / $831.93 / $831.93	Professional		$831.93	$831.93	$831.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.77 / $386.25 / $460.39	Facility		$109.77	$386.25	$460.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $229.50 / $332.82	Professional		$167.54	$229.50	$332.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $857.69 / $857.69 / $857.69	Professional		$857.69	$857.69	$857.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $242.90 / $363.53 / $364.35	Professional		$242.90	$363.53	$364.35
United Facility/Professional Professional Modifier Low / Median / High Price $154.38 / $170.03 / $439.69	Professional		$154.38	$170.03	$439.69