Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.85 / $49.85 / $257.75	Facility		$49.85	$49.85	$257.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.47 / $49.85 / $103.08	Professional		$41.47	$49.85	$103.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $53.60 / $56.15	Professional		$53.60	$53.60	$56.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.85 / $136.96 / $283.58	Facility		$37.85	$136.96	$283.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $49.41 / $86.55	Professional		$45.41	$49.41	$86.55
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $91.81 / $105.77 / $188.87	Facility		$91.81	$105.77	$188.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $118.55 / $276.11	Professional		$48.28	$118.55	$276.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.78 / $56.56 / $64.81	Facility		$41.78	$56.56	$64.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $41.29 / $64.81	Professional		$41.29	$41.29	$64.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $45.72 / $54.86 / $98.27	Professional		$45.72	$54.86	$98.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $62.54 / $138.47	Professional		$53.60	$62.54	$138.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $146.22 / $432.48 / $432.48	Facility		$146.22	$432.48	$432.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $463.22 / $463.22 / $681.38	Professional		$463.22	$463.22	$681.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $191.83 / $191.83 / $191.83	Professional		$191.83	$191.83	$191.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.73 / $77.59 / $93.58	Facility		$26.73	$77.59	$93.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $56.56 / $85.04	Professional		$41.29	$56.56	$85.04
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $168.61 / $168.61 / $168.61	Professional		$168.61	$168.61	$168.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.72 / $71.47 / $71.47	Professional		$45.72	$71.47	$71.47
United Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $44.57 / $123.96	Professional		$39.40	$44.57	$123.96