Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $272.08 / $10,125.00	Facility		$106.33	$272.08	$10,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $116.97 / $3,039.18	Professional		$106.33	$116.97	$3,039.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $265.27 / $502.50	Professional		$136.04	$265.27	$502.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.96 / $169.84 / $380.73	Facility		$113.96	$169.84	$380.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $136.04 / $389.84	Professional		$106.33	$136.04	$389.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $100.00 / $417.50	Facility		$77.09	$100.00	$417.50
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $108.34 / $108.34 / $326.20	Professional		$108.34	$108.34	$326.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $100.32 / $106.33	Facility		$100.32	$100.32	$106.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $162.66	Professional		$106.33	$106.33	$162.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $135.55 / $168.06 / $201.67	Professional		$135.55	$168.06	$201.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.70 / $127.60 / $244.56	Professional		$95.70	$127.60	$244.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $417.50 / $1,433.35 / $1,433.35	Facility		$417.50	$1,433.35	$1,433.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,358.07 / $1,358.07 / $1,358.07	Professional		$1,358.07	$1,358.07	$1,358.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $277.87 / $277.87 / $277.87	Professional		$277.87	$277.87	$277.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $112.77 / $188.41	Facility		$106.33	$112.77	$188.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $200.73	Professional		$106.33	$106.33	$200.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $650.74 / $650.74 / $650.74	Professional		$650.74	$650.74	$650.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $106.33 / $159.50	Professional		$85.07	$106.33	$159.50
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $215.69	Professional		$106.33	$106.33	$215.69