Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.74 / $15.54 / $85.51	Facility	26	$14.74	$15.54	$85.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.83 / $93.78 / $330.28	Professional		$64.83	$93.78	$330.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $14.74 / $64.14	Professional	26	$12.23	$14.74	$64.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $97.00 / $189.47	Professional		$68.94	$97.00	$189.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $20.58 / $41.23	Professional	26	$16.32	$20.58	$41.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $95.76 / $208.50	Professional		$75.20	$95.76	$208.50
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $18.80 / $43.30	Professional	26	$14.81	$18.80	$43.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.56 / $103.62 / $240.95	Professional		$71.56	$103.62	$240.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $19.17 / $41.00	Professional	26	$12.96	$19.17	$41.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $137.00 / $184.95	Professional		$38.09	$137.00	$184.95
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $16.60 / $22.41	Professional	26	$7.62	$16.60	$22.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $134.41 / $226.66	Professional		$102.00	$134.41	$226.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $19.92 / $31.51	Professional	26	$14.75	$19.92	$31.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $137.84 / $137.84 / $141.91	Facility	26	$137.84	$137.84	$141.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $611.40 / $611.40 / $867.00	Professional		$611.40	$611.40	$867.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $163.46 / $163.46 / $163.46	Professional	26	$163.46	$163.46	$163.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $80.36	Professional		$32.34	$32.34	$80.36
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $123.83 / $272.33	Professional		$73.72	$123.83	$272.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.24 / $18.72 / $40.82	Professional	26	$13.24	$18.72	$40.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $296.61 / $296.61 / $296.61	Professional		$296.61	$296.61	$296.61
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $48.32 / $48.32 / $48.32	Professional	26	$48.32	$48.32	$48.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $110.81 / $152.36	Professional		$57.13	$110.81	$152.36
United Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $89.86 / $257.39	Professional		$55.86	$89.86	$257.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $16.39 / $37.39	Professional	26	$12.17	$16.39	$37.39