Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.00 / $140.00 / $673.10	Facility	26	$140.00	$140.00	$673.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.99 / $475.00 / $1,803.93	Professional		$305.99	$475.00	$1,803.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.98 / $266.98 / $266.98	Professional		$266.98	$266.98	$266.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.50 / $580.47 / $1,069.44	Professional		$339.50	$580.47	$1,069.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $262.19 / $400.42 / $979.24	Professional		$262.19	$400.42	$979.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.63 / $488.41 / $945.08	Professional		$238.63	$488.41	$945.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $357.53 / $393.28 / $482.67	Professional		$357.53	$393.28	$482.67
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.24 / $134.46 / $165.02	Professional	26	$122.24	$134.46	$165.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $280.51 / $374.02 / $675.00	Professional		$280.51	$374.02	$675.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $110.02 / $152.80 / $400.00	Professional	26	$110.02	$152.80	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,008.32 / $1,008.32 / $1,031.35	Facility	26	$1,008.32	$1,008.32	$1,031.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,148.28 / $3,148.28 / $3,148.28	Professional		$3,148.28	$3,148.28	$3,148.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $174.64	Professional		$32.34	$32.34	$174.64
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $262.91 / $548.59 / $895.22	Professional		$262.91	$548.59	$895.22
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,065.79 / $1,065.79 / $1,065.79	Professional		$1,065.79	$1,065.79	$1,065.79
United Facility/Professional Professional Modifier Low / Median / High Price $276.39 / $406.69 / $889.74	Professional		$276.39	$406.69	$889.74