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 / $523.65	Facility	26	$140.00	$140.00	$523.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.61 / $97.61 / $97.61	Facility	26	$97.61	$97.61	$97.61
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.59 / $94.33 / $127.35	Professional	26	$71.59	$94.33	$127.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.47 / $113.20 / $216.96	Professional	26	$83.47	$113.20	$216.96
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $777.44 / $777.44 / $799.28	Facility	26	$777.44	$777.44	$799.28
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $97.61 / $97.61 / $97.61	Facility	26	$97.61	$97.61	$97.61