Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.00 / $140.00 / $471.21	Facility	26	$140.00	$140.00	$471.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.60 / $475.00 / $1,388.85	Professional		$271.60	$475.00	$1,388.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.50 / $653.82 / $1,176.84	Professional		$341.50	$653.82	$1,176.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $335.39 / $511.07 / $1,182.83	Professional		$335.39	$511.07	$1,182.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.60 / $87.60 / $87.60	Facility	26	$87.60	$87.60	$87.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.35 / $563.21 / $1,091.65	Professional		$261.35	$563.21	$1,091.65
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $258.95 / $346.24 / $467.42	Professional		$258.95	$346.24	$467.42
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $85.10 / $114.89	Professional	26	$49.20	$85.10	$114.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.08 / $359.61 / $657.78	Professional		$269.08	$359.61	$657.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.59 / $110.63 / $400.00	Professional	26	$76.59	$110.63	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $700.72 / $700.72 / $717.20	Facility	26	$700.72	$700.72	$717.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,348.15 / $3,448.60 / $3,448.60	Professional		$3,348.15	$3,448.60	$3,448.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $279.64	Professional		$32.34	$32.34	$279.64
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $87.60 / $87.60 / $87.60	Facility	26	$87.60	$87.60	$87.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $268.37 / $589.88 / $943.28	Professional		$268.37	$589.88	$943.28
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,017.20 / $1,017.20 / $1,017.20	Professional		$1,017.20	$1,017.20	$1,017.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $280.02 / $362.54 / $440.23	Professional		$280.02	$362.54	$440.23
United Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $415.65 / $918.42	Professional		$263.20	$415.65	$918.42