Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.81 / $39.72 / $245.02	Facility	26	$37.81	$39.72	$245.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $102.16 / $421.21	Professional		$80.75	$102.16	$421.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.69 / $39.69 / $163.33	Professional	26	$32.69	$39.69	$163.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.02 / $132.47 / $260.89	Professional		$97.02	$132.47	$260.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $54.40 / $104.86	Professional	26	$43.64	$54.40	$104.86
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $108.50 / $253.73	Professional		$86.69	$108.50	$253.73
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $50.00 / $106.19	Professional	26	$39.34	$50.00	$106.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $47.27	Facility	26	$47.27	$47.27	$47.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $134.97 / $280.85	Professional		$87.76	$134.97	$280.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $51.77 / $111.65	Professional	26	$35.46	$51.77	$111.65
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $143.51 / $157.86 / $193.74	Professional		$143.51	$157.86	$193.74
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.44 / $52.18 / $64.04	Professional	26	$47.44	$52.18	$64.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $143.29 / $244.00	Professional		$105.91	$143.29	$244.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.53 / $56.93 / $89.19	Professional	26	$41.53	$56.93	$89.19
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $120.26 / $207.39 / $207.39	Facility	26	$120.26	$207.39	$207.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $683.45 / $703.95 / $931.80	Professional		$683.45	$703.95	$931.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $282.35 / $282.35 / $336.60	Professional	26	$282.35	$282.35	$336.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $62.14	Professional		$32.34	$32.34	$62.14
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $47.27	Facility	26	$47.27	$47.27	$47.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.48 / $151.11 / $284.82	Professional		$92.48	$151.11	$284.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $49.92 / $109.39	Professional	26	$36.22	$49.92	$109.39
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $356.14 / $356.14 / $356.14	Professional		$356.14	$356.14	$356.14
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $137.91 / $137.91 / $137.91	Professional	26	$137.91	$137.91	$137.91
United Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $110.04 / $271.13	Professional		$80.43	$110.04	$271.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $45.50 / $102.50	Professional	26	$31.53	$45.50	$102.50