Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.32 / $35.47 / $684.00	Facility	26	$28.32	$35.47	$684.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.50 / $87.62 / $244.00	Professional		$48.50	$87.62	$244.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $57.01 / $199.52	Professional	26	$27.26	$57.01	$199.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.68 / $56.68 / $57.50	Professional		$56.68	$56.68	$57.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.77 / $31.77 / $31.77	Professional	26	$31.77	$31.77	$31.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.66 / $74.13 / $139.33	Professional		$50.66	$74.13	$139.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.02 / $48.87 / $93.82	Professional	26	$32.02	$48.87	$93.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $37.53 / $50.27 / $120.45	Professional		$37.53	$50.27	$120.45
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.58 / $37.71 / $98.31	Professional	26	$26.58	$37.71	$98.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.36 / $61.25 / $176.15	Professional		$45.36	$61.25	$176.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.21 / $37.32 / $110.13	Professional	26	$29.21	$37.32	$110.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $57.85 / $69.42	Professional		$22.80	$57.85	$69.42
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $30.16 / $36.19	Professional	26	$9.11	$30.16	$36.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.06 / $65.08 / $114.99	Professional		$50.06	$65.08	$114.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.16 / $37.96 / $69.37	Professional	26	$27.16	$37.96	$69.37
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.61 / $131.69 / $137.18	Facility	26	$70.61	$131.69	$137.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $348.00 / $358.08 / $422.33	Professional		$348.00	$358.08	$422.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $210.00 / $210.00 / $248.55	Professional	26	$210.00	$210.00	$248.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.36 / $63.40 / $134.28	Professional		$45.36	$63.40	$134.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $37.32 / $88.18	Professional	26	$29.50	$37.32	$88.18
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $155.37 / $155.37 / $155.37	Professional		$155.37	$155.37	$155.37
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $92.21 / $92.21 / $92.21	Professional	26	$92.21	$92.21	$92.21
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $41.04 / $64.20	Professional		$22.80	$41.04	$64.20
United Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $56.62 / $154.62	Professional		$39.54	$56.62	$154.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.37 / $34.81 / $83.07	Professional	26	$24.37	$34.81	$83.07