Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $20.42 / $151.36	Facility	26	$15.85	$20.42	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $151.36 / $275.42	Professional		$57.54	$151.36	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $31.62 / $102.33	Professional	26	$16.60	$31.62	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $27.54 / $57.54	Professional	26	$19.95	$27.54	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $346.74	Professional		$125.89	$199.53	$346.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $54.95	Professional	26	$19.95	$26.30	$54.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $331.13	Professional		$128.82	$186.21	$331.13
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.30 / $54.95	Professional	26	$19.50	$26.30	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $239.88	Professional		$72.44	$138.04	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $24.55 / $54.95	Professional	26	$17.38	$24.55	$54.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $144.54	Professional		$56.23	$107.15	$144.54
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $28.84 / $38.90	Professional	26	$18.62	$28.84	$38.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $208.93	Professional		$79.43	$100.00	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.11 / $53.70	Professional	26	$25.12	$33.11	$53.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $194.98 / $194.98	Professional	26	$154.88	$194.98	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $33.11	Professional		$28.84	$32.36	$33.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $213.80	Professional		$72.44	$141.25	$213.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $48.98	Professional	26	$16.98	$23.44	$48.98
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Professional		$245.47	$245.47	$245.47
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Professional	26	$83.18	$83.18	$83.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $138.04	Professional		$85.11	$104.71	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $288.40	Professional		$72.44	$100.00	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $25.70 / $52.48	Professional	26	$14.45	$25.70	$52.48