Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.89 / $60.63 / $368.52	Facility	26	$57.89	$60.63	$368.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.20 / $325.00 / $1,338.04	Professional		$199.20	$325.00	$1,338.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.99 / $62.24 / $262.45	Professional	26	$51.99	$62.24	$262.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $35.79 / $71.15	Professional	26	$35.79	$35.79	$71.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.92 / $467.01 / $863.72	Professional		$255.92	$467.01	$863.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.96 / $81.72 / $161.88	Professional	26	$56.96	$81.72	$161.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $226.11 / $344.21 / $813.34	Professional		$226.11	$344.21	$813.34
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $56.35 / $76.78 / $185.03	Professional	26	$56.35	$76.78	$185.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.79 / $386.06 / $752.96	Professional		$191.79	$386.06	$752.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $73.83 / $167.87	Professional	26	$36.40	$73.83	$167.87
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $193.14 / $261.58 / $353.13	Professional		$193.14	$261.58	$353.13
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.49 / $66.67 / $90.00	Professional	26	$42.49	$66.67	$90.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $262.66 / $476.00	Professional		$200.00	$262.66	$476.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.01 / $80.00 / $130.01	Professional	26	$59.01	$80.00	$130.01
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $549.76 / $549.76 / $565.04	Facility	26	$549.76	$549.76	$565.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,293.84 / $2,362.66 / $2,362.66	Professional		$2,293.84	$2,362.66	$2,362.66
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $523.40 / $523.40 / $523.40	Professional	26	$523.40	$523.40	$523.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $180.83	Professional		$32.34	$32.34	$180.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $197.82 / $424.06 / $674.24	Professional		$197.82	$424.06	$674.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $72.45 / $161.00	Professional	26	$36.09	$72.45	$161.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $769.93 / $769.93 / $769.93	Professional		$769.93	$769.93	$769.93
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $206.68 / $206.68 / $206.68	Professional	26	$206.68	$206.68	$206.68
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $211.55 / $290.88 / $618.24	Professional		$211.55	$290.88	$618.24
United Facility/Professional Professional Modifier Low / Median / High Price $199.09 / $310.12 / $709.41	Professional		$199.09	$310.12	$709.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.23 / $67.78 / $152.97	Professional	26	$49.23	$67.78	$152.97