Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.25 / $208.25 / $1,328.66	Facility		$208.25	$208.25	$1,328.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.43 / $208.25 / $1,328.66	Professional		$174.43	$208.25	$1,328.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $322.36 / $368.41 / $368.41	Professional		$322.36	$368.41	$368.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.13 / $648.95 / $1,461.80	Facility		$158.13	$648.95	$1,461.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.73 / $210.85 / $429.95	Professional		$210.73	$210.85	$429.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $97.00 / $545.17 / $973.53	Facility		$97.00	$545.17	$973.53
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $611.02 / $1,423.26	Professional		$100.00	$611.02	$1,423.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.38 / $232.98 / $246.15	Facility		$215.38	$232.98	$246.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.08 / $170.08 / $273.20	Professional		$170.08	$170.08	$273.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $246.15 / $295.38 / $506.56	Professional		$246.15	$295.38	$506.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $276.31 / $322.36 / $699.98	Professional		$276.31	$322.36	$699.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $938.49 / $2,187.42 / $2,187.42	Facility		$938.49	$2,187.42	$2,187.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,288.42 / $2,288.42 / $3,317.93	Professional		$2,288.42	$2,288.42	$3,317.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,388.30 / $1,388.30 / $1,388.30	Professional		$1,388.30	$1,388.30	$1,388.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.68 / $391.43 / $462.31	Facility		$111.68	$391.43	$462.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.08 / $232.98 / $348.95	Professional		$170.08	$232.98	$348.95
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $869.18 / $869.18 / $869.18	Professional		$869.18	$869.18	$869.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $246.15 / $368.41 / $369.23	Professional		$246.15	$368.41	$369.23
United Facility/Professional Professional Modifier Low / Median / High Price $165.76 / $208.46 / $616.12	Professional		$165.76	$208.46	$616.12