Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $72.44 / $257.04	Facility	26	$37.15	$72.44	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $416.87	Professional		$79.43	$102.33	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $40.74 / $151.36	Professional	26	$32.36	$40.74	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $295.12	Professional		$100.00	$154.88	$295.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $58.88 / $114.82	Professional	26	$43.65	$58.88	$114.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $269.15	Professional		$102.33	$138.04	$269.15
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $107.15	Professional	26	$45.71	$60.26	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $47.86 / $67.61	Facility	26	$10.23	$47.86	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $251.19	Professional		$87.10	$134.90	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $104.71	Professional	26	$35.48	$52.48	$104.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $162.18 / $199.53	Professional		$147.91	$162.18	$199.53
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $52.48 / $64.57	Professional	26	$47.86	$52.48	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $263.03	Professional		$107.15	$138.04	$263.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $91.20	Professional	26	$41.69	$54.95	$91.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $933.25 / $933.25	Professional		$707.95	$933.25	$933.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $338.84 / $338.84	Professional	26	$281.84	$338.84	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $102.33	Professional		$32.36	$48.98	$102.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $47.86 / $67.61	Facility	26	$10.23	$47.86	$67.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $269.15	Professional		$89.13	$141.25	$269.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $95.50	Professional	26	$35.48	$50.12	$95.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	26	$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $109.65 / $229.09	Professional		$81.28	$109.65	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $43.65 / $87.10	Professional	26	$31.62	$43.65	$87.10