Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.42 / $22.39 / $235.95	Facility	26	$21.42	$22.39	$235.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $116.15 / $349.02	Professional		$96.60	$116.15	$349.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $36.44 / $103.75	Professional	26	$20.17	$36.44	$103.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.14 / $169.14 / $169.14	Professional		$169.14	$169.14	$169.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.78 / $35.45 / $49.73	Professional	26	$22.78	$35.45	$49.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.79 / $124.30 / $253.36	Professional		$85.79	$124.30	$253.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.84 / $32.59 / $68.31	Professional	26	$24.84	$32.59	$68.31
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $126.37 / $280.70	Professional		$100.00	$126.37	$280.70
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $21.55 / $27.31 / $69.97	Professional	26	$21.55	$27.31	$69.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.16 / $135.10 / $323.20	Professional		$89.16	$135.10	$323.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $33.77 / $89.54	Professional	26	$22.70	$33.77	$89.54
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $94.62 / $154.99 / $209.24	Professional		$94.62	$154.99	$209.24
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $42.39 / $57.23	Professional	26	$20.82	$42.39	$57.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.10 / $153.43 / $256.39	Professional		$114.10	$153.43	$256.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $50.87 / $79.69	Professional	26	$37.54	$50.87	$79.69
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $187.10 / $187.10	Facility	26	$100.00	$187.10	$187.10
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $810.58 / $810.58 / $1,004.40	Professional		$810.58	$810.58	$1,004.40
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $242.65 / $242.65 / $307.35	Professional	26	$242.65	$242.65	$307.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $78.95	Professional		$32.34	$32.34	$78.95
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $94.15 / $160.34 / $337.84	Professional		$94.15	$160.34	$337.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.57 / $32.53 / $78.89	Professional	26	$23.57	$32.53	$78.89
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $402.53 / $402.53 / $402.53	Professional		$402.53	$402.53	$402.53
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $132.60 / $132.60 / $132.60	Professional	26	$132.60	$132.60	$132.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $112.97 / $141.01 / $172.35	Professional		$112.97	$141.01	$172.35
United Facility/Professional Professional Modifier Low / Median / High Price $75.77 / $123.07 / $294.58	Professional		$75.77	$123.07	$294.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.26 / $41.86 / $94.81	Professional	26	$18.26	$41.86	$94.81