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 / $895.70	Facility	26	$140.00	$140.00	$895.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.08 / $172.08 / $172.08	Facility	26	$172.08	$172.08	$172.08
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.53 / $171.40 / $231.39	Professional	26	$51.53	$171.40	$231.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $154.26 / $216.48 / $457.64	Professional	26	$154.26	$216.48	$457.64
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $657.79 / $747.75 / $747.75	Facility	26	$657.79	$747.75	$747.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $172.08 / $172.08 / $172.08	Facility	26	$172.08	$172.08	$172.08