Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.33 / $86.92 / $518.22	Facility	26	$81.33	$86.92	$518.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.17 / $408.66 / $1,347.71	Professional		$258.17	$408.66	$1,347.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.03 / $91.25 / $439.00	Professional	26	$78.03	$91.25	$439.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.62 / $69.86 / $155.31	Professional	26	$62.62	$69.86	$155.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.27 / $530.01 / $973.46	Professional		$323.27	$530.01	$973.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.90 / $103.70 / $210.16	Professional	26	$78.90	$103.70	$210.16
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $269.29 / $413.37 / $976.27	Professional		$269.29	$413.37	$976.27
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $79.58 / $107.93 / $257.33	Professional	26	$79.58	$107.93	$257.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.58 / $463.35 / $963.32	Professional		$247.58	$463.35	$963.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.60 / $100.69 / $237.25	Professional	26	$51.60	$100.69	$237.25
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $291.05 / $345.10 / $465.89	Professional		$291.05	$345.10	$465.89
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.67 / $93.60 / $126.36	Professional	26	$75.67	$93.60	$126.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $287.60 / $389.10 / $691.22	Professional		$287.60	$389.10	$691.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.10 / $112.32 / $177.74	Professional	26	$83.10	$112.32	$177.74
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $776.08 / $776.08 / $792.40	Facility	26	$776.08	$776.08	$792.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,854.54 / $2,940.17 / $2,940.17	Professional		$2,854.54	$2,940.17	$2,940.17
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $536.20 / $536.20 / $683.18	Professional	26	$536.20	$536.20	$683.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $206.39	Professional		$32.34	$32.34	$206.39
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $257.77 / $533.37 / $926.99	Professional		$257.77	$533.37	$926.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.58 / $96.43 / $220.83	Professional	26	$51.58	$96.43	$220.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,095.04 / $1,095.04 / $1,095.04	Professional		$1,095.04	$1,095.04	$1,095.04
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $291.26 / $291.26 / $291.26	Professional	26	$291.26	$291.26	$291.26
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $279.08 / $383.74 / $494.78	Professional		$279.08	$383.74	$494.78
United Facility/Professional Professional Modifier Low / Median / High Price $283.45 / $378.84 / $856.92	Professional		$283.45	$378.84	$856.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.25 / $91.67 / $202.58	Professional	26	$70.25	$91.67	$202.58