Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.68 / $58.30 / $353.83	Facility	26	$55.68	$58.30	$353.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.62 / $349.00 / $1,225.92	Professional		$228.62	$349.00	$1,225.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.41 / $60.00 / $302.00	Professional	26	$51.41	$60.00	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $185.18 / $329.07 / $329.07	Professional		$185.18	$329.07	$329.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.04 / $46.88 / $128.43	Professional	26	$43.04	$46.88	$128.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.83 / $458.06 / $839.09	Professional		$269.83	$458.06	$839.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.69 / $78.03 / $151.63	Professional	26	$54.69	$78.03	$151.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $230.37 / $354.66 / $846.44	Professional		$230.37	$354.66	$846.44
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $54.11 / $73.79 / $177.64	Professional	26	$54.11	$73.79	$177.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.30 / $388.73 / $824.78	Professional		$205.30	$388.73	$824.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.70 / $68.52 / $162.26	Professional	26	$34.70	$68.52	$162.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $247.35 / $315.35 / $425.72	Professional		$247.35	$315.35	$425.72
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $63.39 / $85.58	Professional	26	$51.94	$63.39	$85.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.67 / $328.21 / $557.96	Professional		$239.67	$328.21	$557.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.12 / $76.06 / $123.61	Professional	26	$56.12	$76.06	$123.61
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $522.72 / $522.72 / $537.20	Facility	26	$522.72	$522.72	$537.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,022.16 / $2,077.23 / $2,077.23	Professional		$2,022.16	$2,077.23	$2,077.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $394.61 / $394.61 / $456.90	Professional	26	$394.61	$394.61	$456.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $222.87	Professional		$32.34	$32.34	$222.87
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $214.06 / $466.48 / $787.03	Professional		$214.06	$466.48	$787.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.53 / $66.20 / $159.80	Professional	26	$33.53	$66.20	$159.80
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $929.51 / $929.51 / $929.51	Professional		$929.51	$929.51	$929.51
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $198.51 / $198.51 / $198.51	Professional	26	$198.51	$198.51	$198.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $255.06 / $350.70 / $743.34	Professional		$255.06	$350.70	$743.34
United Facility/Professional Professional Modifier Low / Median / High Price $239.89 / $320.62 / $805.55	Professional		$239.89	$320.62	$805.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.29 / $62.44 / $148.41	Professional	26	$47.29	$62.44	$148.41