Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $323.59 / $741.31	Facility	26	$112.20	$323.59	$741.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $138.04 / $194.98	Facility	26	$29.51	$138.04	$194.98
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $134.90 / $181.97	Professional	26	$91.20	$134.90	$181.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $158.49 / $257.04	Professional	26	$120.23	$158.49	$257.04
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility	26	$1,096.48	$1,096.48	$1,096.48
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $138.04 / $194.98	Facility	26	$29.51	$138.04	$194.98