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 / $1,014.58	Facility	26	$140.00	$140.00	$1,014.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $189.68 / $189.68 / $189.68	Facility	26	$189.68	$189.68	$189.68
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $189.59 / $255.95	Professional	26	$53.18	$189.59	$255.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $170.63 / $239.45 / $506.21	Professional	26	$170.63	$239.45	$506.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $731.04 / $827.26 / $827.26	Facility	26	$731.04	$827.26	$827.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $189.68 / $189.68 / $189.68	Facility	26	$189.68	$189.68	$189.68