Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.50 / $102.50 / $537.91	Facility		$102.50	$102.50	$537.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.55 / $102.50 / $387.04	Professional		$94.55	$102.50	$387.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.03 / $144.03 / $144.03	Professional		$144.03	$144.03	$144.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $282.91 / $591.78	Facility		$77.84	$282.91	$591.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.20 / $103.75 / $177.67	Professional		$93.20	$103.75	$177.67
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $96.60 / $220.74 / $394.18	Facility		$96.60	$220.74	$394.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $247.37 / $576.21	Professional		$100.00	$247.37	$576.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.21 / $106.63 / $121.71	Facility		$87.21	$106.63	$121.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $77.84 / $121.71	Professional		$77.84	$77.84	$121.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $99.66 / $119.59 / $205.07	Professional		$99.66	$119.59	$205.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.86 / $130.50 / $294.56	Professional		$111.86	$130.50	$294.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $320.95 / $889.53 / $889.53	Facility		$320.95	$889.53	$889.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $961.74 / $961.74 / $1,398.23	Professional		$961.74	$961.74	$1,398.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $393.68 / $393.68 / $393.68	Professional		$393.68	$393.68	$393.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.96 / $163.25 / $192.04	Facility		$54.96	$163.25	$192.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $106.63 / $177.45	Professional		$77.84	$106.63	$177.45
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $351.89 / $351.89 / $351.89	Professional		$351.89	$351.89	$351.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $99.66 / $149.13 / $149.49	Professional		$99.66	$149.13	$149.49
United Facility/Professional Professional Modifier Low / Median / High Price $78.72 / $85.13 / $196.55	Professional		$78.72	$85.13	$196.55