Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.81 / $140.00 / $140.00	Facility	26	$71.81	$140.00	$140.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.53 / $425.00 / $546.25	Professional		$55.53	$425.00	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $140.00 / $395.04	Professional	26	$14.49	$140.00	$395.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.64 / $114.14 / $207.90	Professional		$60.64	$114.14	$207.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.19 / $15.41 / $30.94	Professional	26	$11.19	$15.41	$30.94
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $71.84 / $171.20	Professional		$55.15	$71.84	$171.20
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.09 / $38.99	Professional	26	$10.96	$15.09	$38.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $80.23 / $163.66	Professional		$39.65	$80.23	$163.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.10 / $14.46 / $32.90	Professional	26	$7.10	$14.46	$32.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $45.76 / $59.43 / $80.23	Professional		$45.76	$59.43	$80.23
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $13.07 / $17.64	Professional	26	$9.61	$13.07	$17.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $61.59 / $350.00	Professional		$45.79	$61.59	$350.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.76 / $16.34 / $34.90	Professional	26	$11.76	$16.34	$34.90
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.00 / $80.00 / $80.00	Facility	26	$70.00	$80.00	$80.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $353.51 / $371.18 / $379.80	Professional		$353.51	$371.18	$379.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.64 / $74.64 / $94.05	Professional	26	$74.64	$74.64	$94.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $36.83	Professional		$32.34	$32.34	$36.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $90.28 / $150.01	Professional		$42.82	$90.28	$150.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $14.08 / $32.72	Professional	26	$6.46	$14.08	$32.72
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $176.10 / $176.10 / $176.10	Professional		$176.10	$176.10	$176.10
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.26 / $40.26 / $40.26	Professional	26	$40.26	$40.26	$40.26
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $48.07 / $64.06 / $77.80	Professional		$48.07	$64.06	$77.80
United Facility/Professional Professional Modifier Low / Median / High Price $45.40 / $69.97 / $154.33	Professional		$45.40	$69.97	$154.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $13.43 / $32.92	Professional	26	$9.94	$13.43	$32.92