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 / $500.09	Facility	26	$140.00	$140.00	$500.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.76 / $93.76 / $93.76	Facility	26	$93.76	$93.76	$93.76
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.34 / $90.49 / $122.16	Professional	26	$67.34	$90.49	$122.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.44 / $117.64 / $400.00	Professional	26	$81.44	$117.64	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $746.48 / $746.48 / $767.44	Facility	26	$746.48	$746.48	$767.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $93.76 / $93.76 / $93.76	Facility	26	$93.76	$93.76	$93.76