Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.42 / $200.42 / $1,012.86	Facility		$200.42	$200.42	$1,012.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.32 / $200.42 / $1,012.86	Professional		$170.32	$200.42	$1,012.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.74 / $268.41 / $280.83	Professional		$245.74	$268.41	$280.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.19 / $538.16 / $1,114.33	Facility		$152.19	$538.16	$1,114.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.59 / $202.82 / $332.83	Professional		$174.59	$202.82	$332.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $415.63 / $742.20	Facility		$97.00	$415.63	$742.20
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $465.78 / $1,084.95	Professional		$100.00	$465.78	$1,084.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.19 / $209.59 / $209.59	Facility		$164.19	$209.59	$209.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $223.43	Professional		$153.00	$153.00	$223.43
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $129.91 / $386.16	Professional		$108.27	$129.91	$386.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.63 / $245.74 / $544.13	Professional		$210.63	$245.74	$544.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $667.37 / $1,729.07 / $1,729.07	Facility		$667.37	$1,729.07	$1,729.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,202.30 / $2,202.30 / $2,960.93	Professional		$2,202.30	$2,202.30	$2,960.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,336.06 / $1,336.06 / $1,336.06	Professional		$1,336.06	$1,336.06	$1,336.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.47 / $310.37 / $368.60	Facility		$107.47	$310.37	$368.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $209.59 / $338.87	Professional		$153.00	$209.59	$338.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $662.59 / $662.59 / $662.59	Professional		$662.59	$662.59	$662.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $184.06 / $280.83	Professional		$108.27	$184.06	$280.83
United Facility/Professional Facility Modifier Low / Median / High Price $27.50 / $219.98 / $256.52	Facility		$27.50	$219.98	$256.52
United Facility/Professional Professional Modifier Low / Median / High Price $156.69 / $173.57 / $351.61	Professional		$156.69	$173.57	$351.61