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 / $517.27	Facility	26	$140.00	$140.00	$517.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.98 / $475.00 / $1,816.51	Professional		$281.98	$475.00	$1,816.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.97 / $140.00 / $504.35	Professional	26	$87.97	$140.00	$504.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.34 / $228.34 / $228.34	Professional		$228.34	$228.34	$228.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.37 / $659.87 / $1,223.78	Professional		$339.37	$659.87	$1,223.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.17 / $123.41 / $241.00	Professional	26	$85.17	$123.41	$241.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $265.76 / $407.98 / $993.49	Professional		$265.76	$407.98	$993.49
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $79.05 / $107.15 / $261.32	Professional	26	$79.05	$107.15	$261.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.77 / $547.52 / $1,058.65	Professional		$257.77	$547.52	$1,058.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $105.38 / $238.75	Professional	26	$51.50	$105.38	$238.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $267.74 / $357.98 / $483.27	Professional		$267.74	$357.98	$483.27
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.61 / $93.63 / $126.40	Professional	26	$69.61	$93.63	$126.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $278.67 / $372.65 / $681.19	Professional		$278.67	$372.65	$681.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.27 / $121.72 / $400.00	Professional	26	$84.27	$121.72	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $771.20 / $771.20 / $789.76	Facility	26	$771.20	$771.20	$789.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,480.43 / $3,584.85 / $3,584.85	Professional		$3,480.43	$3,584.85	$3,584.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $701.72 / $701.72 / $701.72	Professional	26	$701.72	$701.72	$701.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $200.72	Professional		$32.34	$32.34	$200.72
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $268.55 / $587.65 / $924.41	Professional		$268.55	$587.65	$924.41
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $49.30 / $102.58 / $237.40	Professional	26	$49.30	$102.58	$237.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,045.25 / $1,045.25 / $1,045.25	Professional		$1,045.25	$1,045.25	$1,045.25
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $290.20 / $290.20 / $290.20	Professional	26	$290.20	$290.20	$290.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $289.52 / $398.09 / $1,665.43	Professional		$289.52	$398.09	$1,665.43
United Facility/Professional Professional Modifier Low / Median / High Price $270.56 / $415.84 / $923.83	Professional		$270.56	$415.84	$923.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.39 / $98.28 / $252.69	Professional	26	$74.39	$98.28	$252.69