Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.19 / $47.39 / $364.14	Facility	26	$45.19	$47.39	$364.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.06 / $209.97 / $961.00	Professional		$165.06	$209.97	$961.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.60 / $53.22 / $159.09	Professional	26	$40.60	$53.22	$159.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.54 / $50.41 / $85.67	Professional	26	$39.54	$50.41	$85.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.53 / $236.33 / $491.01	Professional		$157.53	$236.33	$491.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $64.78 / $133.56	Professional	26	$51.87	$64.78	$133.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $168.19 / $258.79 / $557.83	Professional		$168.19	$258.79	$557.83
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.80 / $58.04 / $129.59	Professional	26	$45.80	$58.04	$129.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.35 / $258.33 / $603.38	Professional		$172.35	$258.33	$603.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $65.18 / $145.21	Professional	26	$43.65	$65.18	$145.21
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $62.84 / $280.04 / $378.05	Professional		$62.84	$280.04	$378.05
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $65.86 / $88.91	Professional	26	$13.82	$65.86	$88.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.37 / $276.27 / $461.48	Professional		$205.37	$276.27	$461.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.32 / $79.03 / $123.82	Professional	26	$58.32	$79.03	$123.82
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $140.44 / $290.64 / $290.64	Facility	26	$140.44	$290.64	$290.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,471.51 / $1,471.51 / $1,803.15	Professional		$1,471.51	$1,471.51	$1,803.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $378.45 / $378.45 / $476.93	Professional	26	$378.45	$378.45	$476.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $151.47	Professional		$32.34	$32.34	$151.47
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $68.29 / $68.29 / $68.29	Facility	26	$68.29	$68.29	$68.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.36 / $296.93 / $612.78	Professional		$177.36	$296.93	$612.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.44 / $64.09 / $135.38	Professional	26	$47.44	$64.09	$135.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $739.93 / $739.93 / $739.93	Professional		$739.93	$739.93	$739.93
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $204.32 / $204.32 / $204.32	Professional	26	$204.32	$204.32	$204.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $94.26 / $226.49 / $311.42	Professional		$94.26	$226.49	$311.42
United Facility/Professional Professional Modifier Low / Median / High Price $150.44 / $225.20 / $590.73	Professional		$150.44	$225.20	$590.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.44 / $64.23 / $166.73	Professional	26	$38.44	$64.23	$166.73