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 / $731.41	Facility	26	$140.00	$140.00	$731.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.26 / $135.26 / $135.26	Facility	26	$135.26	$135.26	$135.26
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.01 / $130.74 / $176.50	Professional	26	$99.01	$130.74	$176.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $116.07 / $163.43 / $288.27	Professional	26	$116.07	$163.43	$288.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $280.44 / $578.22 / $578.22	Facility	26	$280.44	$578.22	$578.22
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $135.26 / $135.26 / $135.26	Facility	26	$135.26	$135.26	$135.26