Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.76 / $28.03 / $165.88	Facility	26	$26.76	$28.03	$165.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $133.72 / $313.85	Professional		$104.08	$133.72	$313.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.86 / $28.03 / $81.30	Professional	26	$23.86	$28.03	$81.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.89 / $48.89 / $48.89	Professional	26	$48.89	$48.89	$48.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.34 / $154.38 / $327.07	Professional		$114.34	$154.38	$327.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $39.61 / $123.53	Professional	26	$27.23	$39.61	$123.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $144.03 / $176.15 / $242.59	Professional	50	$144.03	$176.15	$242.59
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $136.65 / $337.43	Professional		$100.00	$136.65	$337.43
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.69 / $29.82 / $74.56	Professional	26	$23.69	$29.82	$74.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.88 / $163.88 / $354.52	Professional		$104.88	$163.88	$354.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.59 / $34.79 / $76.29	Professional	26	$24.59	$34.79	$76.29
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.71 / $164.71 / $187.81	Professional	50	$164.71	$164.71	$187.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $69.22 / $139.72 / $188.64	Professional		$69.22	$139.72	$188.64
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $33.56 / $45.31	Professional	26	$15.92	$33.56	$45.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.60 / $138.82 / $230.56	Professional		$102.60	$138.82	$230.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.63 / $40.27 / $63.09	Professional	26	$29.63	$40.27	$63.09
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $148.53 / $148.53	Facility	26	$100.00	$148.53	$148.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $963.76 / $963.76 / $963.76	Professional		$963.76	$963.76	$963.76
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $236.11 / $236.11 / $250.13	Professional	26	$236.11	$236.11	$250.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $89.96	Professional		$32.34	$32.34	$89.96
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	26	$34.86	$34.86	$34.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.06 / $180.39 / $383.02	Professional		$108.06	$180.39	$383.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.59 / $33.67 / $74.86	Professional	26	$24.59	$33.67	$74.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $455.58 / $455.58 / $455.58	Professional		$455.58	$455.58	$455.58
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $93.08 / $93.08 / $93.08	Professional	26	$93.08	$93.08	$93.08
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $139.00 / $168.79	Professional		$103.83	$139.00	$168.79
United Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $138.58 / $333.25	Professional		$94.64	$138.58	$333.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $30.24 / $69.65	Professional	26	$22.13	$30.24	$69.65