Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $229.09 / $524.81	Facility	26	$141.25	$229.09	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $478.63 / $1,819.70	Professional		$288.40	$478.63	$1,819.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $489.78	Professional	26	$85.11	$141.25	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	26	$134.90	$134.90	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $758.58 / $1,230.27	Professional		$446.68	$758.58	$1,230.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $134.90 / $251.19	Professional	26	$93.33	$134.90	$251.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $537.03 / $1,000.00	Professional		$380.19	$537.03	$1,000.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $141.25 / $263.03	Professional	26	$102.33	$141.25	$263.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $95.50 / $138.04	Facility	26	$20.42	$95.50	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $512.86 / $1,000.00	Professional		$269.15	$512.86	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $112.20 / $218.78	Professional	26	$60.26	$112.20	$218.78
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $489.78	Professional		$269.15	$363.08	$489.78
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $95.50 / $128.82	Professional	26	$69.18	$95.50	$128.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $354.81 / $707.95	Professional		$263.03	$354.81	$707.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $112.20 / $208.93	Professional	26	$85.11	$112.20	$208.93
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Professional		$3,548.13	$3,548.13	$3,548.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $707.95 / $707.95 / $707.95	Professional	26	$707.95	$707.95	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $100.00 / $323.59	Professional		$32.36	$100.00	$323.59
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $95.50 / $138.04	Facility	26	$20.42	$95.50	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $549.54 / $912.01	Professional		$269.15	$549.54	$912.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $107.15 / $186.21	Professional	26	$54.95	$107.15	$186.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Professional	26	$288.40	$288.40	$288.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $1,659.59	Professional		$295.12	$407.38	$1,659.59
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $398.11 / $831.76	Professional		$269.15	$398.11	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $181.97	Professional	26	$69.18	$89.13	$181.97