Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.00 / $140.00 / $471.21	Facility	26	$140.00	$140.00	$471.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.83 / $475.00 / $1,485.26	Professional		$276.83	$475.00	$1,485.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.82 / $653.82 / $1,176.84	Professional		$359.82	$653.82	$1,176.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $333.61 / $508.33 / $1,181.44	Professional		$333.61	$508.33	$1,181.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.60 / $87.60 / $87.60	Facility	26	$87.60	$87.60	$87.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.24 / $560.54 / $1,091.65	Professional		$255.24	$560.54	$1,091.65
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $264.83 / $352.67 / $476.10	Professional		$264.83	$352.67	$476.10
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.91 / $85.10 / $114.89	Professional	26	$60.91	$85.10	$114.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $273.95 / $366.68 / $669.68	Professional		$273.95	$366.68	$669.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.59 / $110.63 / $400.00	Professional	26	$76.59	$110.63	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $700.72 / $700.72 / $717.20	Facility	26	$700.72	$700.72	$717.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,348.15 / $3,448.60 / $3,448.60	Professional		$3,348.15	$3,448.60	$3,448.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $277.79	Professional		$32.34	$32.34	$277.79
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $87.60 / $87.60 / $87.60	Facility	26	$87.60	$87.60	$87.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $269.00 / $594.12 / $936.20	Professional		$269.00	$594.12	$936.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,034.03 / $1,034.03 / $1,034.03	Professional		$1,034.03	$1,034.03	$1,034.03
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $285.22 / $370.78 / $450.23	Professional		$285.22	$370.78	$450.23
United Facility/Professional Professional Modifier Low / Median / High Price $267.50 / $415.55 / $914.36	Professional		$267.50	$415.55	$914.36