Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.38 / $23.41 / $141.63	Facility	26	$22.38	$23.41	$141.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.78 / $122.08 / $488.51	Professional		$96.78	$122.08	$488.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.69 / $22.38 / $93.43	Professional	26	$19.69	$22.38	$93.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $136.65 / $268.27	Professional		$97.00	$136.65	$268.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.19 / $31.90 / $65.30	Professional	26	$25.19	$31.90	$65.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $133.79 / $301.31	Professional		$100.00	$133.79	$301.31
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.54 / $28.59 / $65.78	Professional	26	$22.54	$28.59	$65.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.30 / $145.16 / $338.35	Professional		$99.30	$145.16	$338.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $29.74 / $64.81	Professional	26	$20.38	$29.74	$64.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $175.72 / $237.22	Professional		$65.73	$175.72	$237.22
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.81 / $25.34 / $34.21	Professional	26	$13.81	$25.34	$34.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.73 / $172.81 / $279.00	Professional		$127.73	$172.81	$279.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.44 / $30.41 / $47.64	Professional	26	$22.44	$30.41	$47.64
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $111.77 / $111.77	Facility	26	$100.00	$111.77	$111.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $893.01 / $893.01 / $1,115.78	Professional		$893.01	$893.01	$1,115.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $188.00 / $188.00 / $188.00	Professional	26	$188.00	$188.00	$188.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $104.10	Professional		$32.34	$32.34	$104.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.23 / $167.12 / $371.08	Professional		$100.23	$167.12	$371.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $28.87 / $64.56	Professional	26	$20.68	$28.87	$64.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $428.64 / $428.64 / $428.64	Professional		$428.64	$428.64	$428.64
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.37 / $79.37 / $79.37	Professional	26	$79.37	$79.37	$79.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $98.61 / $159.88 / $195.42	Professional		$98.61	$159.88	$195.42
United Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $129.91 / $323.14	Professional		$80.20	$129.91	$323.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $26.12 / $64.92	Professional	26	$18.80	$26.12	$64.92