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 / $613.84	Facility	26	$140.00	$140.00	$613.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.94 / $114.94 / $114.94	Facility	26	$114.94	$114.94	$114.94
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.28 / $111.47 / $150.47	Professional	26	$82.28	$111.47	$150.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $98.78 / $139.34 / $245.66	Professional	26	$98.78	$139.34	$245.66
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $237.22 / $492.86 / $492.86	Facility	26	$237.22	$492.86	$492.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $114.94 / $114.94 / $114.94	Facility	26	$114.94	$114.94	$114.94