Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $43.65 / $144.54	Facility	26	$21.88	$43.65	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $467.74	Professional		$93.33	$128.82	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $81.28	Professional	26	$18.20	$22.91	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.05 / $19.05	Professional	26	$19.05	$19.05	$19.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $309.03	Professional		$107.15	$141.25	$309.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $34.67 / $67.61	Professional	26	$25.70	$34.67	$67.61
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $316.23	Professional		$123.03	$162.18	$316.23
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $35.48 / $63.10	Professional	26	$26.92	$35.48	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $144.54 / $295.12	Professional		$100.00	$144.54	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.20 / $60.26	Professional	26	$20.42	$30.20	$60.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $177.83 / $239.88	Professional		$66.07	$177.83	$239.88
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $25.70 / $35.48	Professional	26	$13.80	$25.70	$35.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $281.84	Professional		$128.82	$165.96	$281.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.20 / $48.98	Professional	26	$22.91	$30.20	$48.98
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	26	$144.54	$144.54	$144.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,122.02	Professional		$891.25	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	26	$186.21	$186.21	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $128.82	Professional		$28.18	$33.11	$128.82
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $316.23	Professional		$100.00	$151.36	$316.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.84 / $56.23	Professional	26	$20.42	$28.84	$56.23
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	26	$79.43	$79.43	$79.43
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $169.82	Professional		$97.72	$147.91	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $275.42	Professional		$79.43	$128.82	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.12 / $50.12	Professional	26	$17.78	$25.12	$50.12