Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.74 / $316.74 / $1,521.56	Facility		$316.74	$316.74	$1,521.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.98 / $316.74 / $1,521.56	Professional		$250.98	$316.74	$1,521.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $395.52 / $395.52 / $395.52	Professional		$395.52	$395.52	$395.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $240.53 / $808.44 / $1,674.00	Facility		$240.53	$808.44	$1,674.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.26 / $319.89 / $490.44	Professional		$257.26	$319.89	$490.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $98.20 / $624.35 / $1,114.91	Facility		$98.20	$624.35	$1,114.91
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $699.72 / $1,629.89	Professional		$100.00	$699.72	$1,629.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $246.66 / $329.53 / $329.53	Facility		$246.66	$329.53	$329.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.56 / $240.56 / $351.29	Professional		$240.56	$240.56	$351.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $231.00 / $580.10	Professional		$192.50	$231.00	$580.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.42 / $369.15 / $801.59	Professional		$316.42	$369.15	$801.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,054.73 / $2,777.21 / $2,777.21	Facility		$1,054.73	$2,777.21	$2,777.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,480.59 / $3,480.59 / $5,273.63	Professional		$3,480.59	$3,480.59	$5,273.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,441.45 / $1,441.45 / $1,441.45	Professional		$1,441.45	$1,441.45	$1,441.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $169.85 / $466.23 / $553.73	Facility		$169.85	$466.23	$553.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $240.56 / $329.53 / $501.95	Professional		$240.56	$329.53	$501.95
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $995.37 / $995.37 / $995.37	Professional		$995.37	$995.37	$995.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $327.25 / $421.89	Professional		$192.50	$327.25	$421.89
United Facility/Professional Professional Modifier Low / Median / High Price $247.65 / $267.70 / $527.36	Professional		$247.65	$267.70	$527.36