Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.71 / $17.43 / $147.51	Facility	26	$16.71	$17.43	$147.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.54 / $188.28 / $277.55	Professional		$69.54	$188.28	$277.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $29.71 / $95.82	Professional	26	$16.35	$29.71	$95.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.13 / $36.94 / $55.19	Professional	26	$20.13	$36.94	$55.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.44 / $214.89 / $356.22	Professional		$127.44	$214.89	$356.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $25.00 / $49.77	Professional	26	$19.55	$25.00	$49.77
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $142.32 / $324.33	Professional		$100.00	$142.32	$324.33
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.50 / $20.69 / $55.19	Professional	26	$17.50	$20.69	$55.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.80 / $27.80	Facility	26	$27.80	$27.80	$27.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.83 / $139.21 / $263.94	Professional		$74.83	$139.21	$263.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.04 / $24.46 / $62.09	Professional	26	$17.04	$24.46	$62.09
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $100.89 / $136.19	Professional		$56.42	$100.89	$136.19
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $27.31 / $36.86	Professional	26	$18.62	$27.31	$36.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $99.83 / $189.67	Professional		$74.23	$99.83	$189.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.14 / $32.77 / $51.34	Professional	26	$24.14	$32.77	$51.34
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $120.22 / $120.22	Facility	26	$100.00	$120.22	$120.22
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $676.85 / $697.16 / $697.16	Professional		$676.85	$697.16	$697.16
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $153.55 / $153.55 / $196.13	Professional	26	$153.55	$153.55	$196.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $32.34 / $32.34	Professional		$28.70	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.80 / $27.80	Facility	26	$27.80	$27.80	$27.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $147.71 / $235.02	Professional		$83.49	$147.71	$235.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $24.03 / $54.75	Professional	26	$17.55	$24.03	$54.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $245.77 / $245.77 / $245.77	Professional		$245.77	$245.77	$245.77
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $82.83 / $82.83 / $82.83	Professional	26	$82.83	$82.83	$82.83
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $112.20 / $137.58	Professional		$81.59	$112.20	$137.58
United Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $99.23 / $325.52	Professional		$75.06	$99.23	$325.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.38 / $25.98 / $64.59	Professional	26	$14.38	$25.98	$64.59