Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.78 / $40.77 / $247.26	Facility	26	$38.78	$40.77	$247.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.08 / $117.29 / $617.92	Professional		$91.08	$117.29	$617.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.14 / $38.78 / $162.72	Professional	26	$33.14	$38.78	$162.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $165.22 / $407.86	Professional		$108.99	$165.22	$407.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.17 / $54.70 / $151.11	Professional	26	$39.17	$54.70	$151.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $149.56 / $342.25	Professional		$100.00	$149.56	$342.25
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $42.44 / $102.90	Professional	26	$30.53	$42.44	$102.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.12 / $45.12 / $45.12	Facility	26	$45.12	$45.12	$45.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.23 / $168.51 / $430.17	Professional		$89.23	$168.51	$430.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $50.74 / $113.20	Professional	26	$35.97	$50.74	$113.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $141.93 / $191.61	Professional		$87.48	$141.93	$191.61
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.74 / $44.01 / $59.41	Professional	26	$36.74	$44.01	$59.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.83 / $140.90 / $235.56	Professional		$104.83	$140.90	$235.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $52.81 / $83.60	Professional	26	$38.90	$52.81	$83.60
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $110.44 / $193.99 / $193.99	Facility	26	$110.44	$193.99	$193.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,963.99 / $2,022.91 / $2,022.91	Professional		$1,963.99	$2,022.91	$2,022.91
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $549.82 / $549.82 / $549.82	Professional	26	$549.82	$549.82	$549.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $65.81	Professional		$32.34	$32.34	$65.81
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $45.12 / $45.12 / $45.12	Facility	26	$45.12	$45.12	$45.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.06 / $190.94 / $387.96	Professional		$93.06	$190.94	$387.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $49.60 / $108.57	Professional	26	$35.97	$49.60	$108.57
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $355.55 / $355.55 / $355.55	Professional		$355.55	$355.55	$355.55
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $138.51 / $138.51 / $138.51	Professional	26	$138.51	$138.51	$138.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $114.78 / $157.82 / $399.33	Professional		$114.78	$157.82	$399.33
United Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $137.57 / $371.46	Professional		$102.05	$137.57	$371.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $44.14 / $107.27	Professional	26	$31.53	$44.14	$107.27