Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $162.18 / $524.81	Facility	26	$81.28	$162.18	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $436.52 / $1,513.56	Professional		$218.78	$436.52	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $120.23 / $436.52	Professional	26	$77.62	$120.23	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $181.97 / $194.98	Professional	26	$144.54	$181.97	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $1,047.13	Professional		$371.54	$575.44	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $239.88	Professional	26	$79.43	$107.15	$239.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $549.54 / $1,000.00	Professional		$389.05	$549.54	$1,000.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $141.25 / $257.04	Professional	26	$104.71	$141.25	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $457.09 / $912.01	Professional		$251.19	$457.09	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $102.33 / $208.93	Professional	26	$60.26	$102.33	$208.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $346.74 / $467.74	Professional		$288.40	$346.74	$467.74
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $93.33 / $125.89	Professional	26	$75.86	$93.33	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $371.54 / $707.95	Professional		$288.40	$371.54	$707.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $109.65 / $177.83	Professional	26	$83.18	$109.65	$177.83
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 $2,951.21 / $2,951.21 / $2,951.21	Professional		$2,951.21	$2,951.21	$2,951.21
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $537.03 / $676.08 / $676.08	Professional	26	$537.03	$676.08	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $100.00 / $288.40	Professional		$32.36	$100.00	$288.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $489.78 / $851.14	Professional		$251.19	$489.78	$851.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $95.50 / $177.83	Professional	26	$51.29	$95.50	$177.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
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 $281.84 / $380.19 / $489.78	Professional		$281.84	$380.19	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $776.25	Professional		$281.84	$380.19	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $87.10 / $181.97	Professional	26	$66.07	$87.10	$181.97