Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $28.18 / $93.33	Facility	26	$14.13	$28.18	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $416.87	Professional		$64.57	$93.33	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $67.61	Professional	26	$12.02	$15.14	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $213.80	Professional		$74.13	$102.33	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.39 / $41.69	Professional	26	$16.60	$22.39	$41.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $223.87	Professional		$87.10	$112.20	$223.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $22.91 / $40.74	Professional	26	$17.78	$22.91	$40.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $213.80	Professional		$72.44	$104.71	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.50 / $38.02	Professional	26	$12.88	$19.50	$38.02
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $138.04 / $186.21	Professional		$38.02	$138.04	$186.21
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $17.78 / $23.99	Professional	26	$7.59	$17.78	$23.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $229.09	Professional		$100.00	$128.82	$229.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $20.42 / $33.11	Professional	26	$15.49	$20.42	$33.11
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $870.96 / $870.96	Professional		$616.60	$870.96	$870.96
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	26	$162.18	$162.18	$162.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $33.11 / $95.50	Professional		$15.49	$33.11	$95.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $234.42	Professional		$72.44	$109.65	$234.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $18.62 / $35.48	Professional	26	$12.88	$18.62	$35.48
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Professional		$295.12	$295.12	$295.12
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	26	$47.86	$47.86	$47.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $93.33 / $125.89	Professional		$57.54	$93.33	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $89.13 / $194.98	Professional		$56.23	$89.13	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.49 / $31.62	Professional	26	$11.48	$15.49	$31.62