Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.57 / $86.58 / $547.85	Facility	26	$82.57	$86.58	$547.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.81 / $250.13 / $456.49	Professional		$141.81	$250.13	$456.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.76 / $84.12 / $243.70	Professional	26	$77.76	$84.12	$243.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.34 / $73.34 / $73.34	Professional	26	$73.34	$73.34	$73.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.26 / $330.94 / $735.10	Professional		$176.26	$330.94	$735.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.21 / $127.07 / $341.82	Professional	26	$88.21	$127.07	$341.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $184.32 / $297.74 / $661.96	Professional		$184.32	$297.74	$661.96
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $76.05 / $96.20 / $233.85	Professional	26	$76.05	$96.20	$233.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.58 / $309.55 / $763.48	Professional		$144.58	$309.55	$763.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.25 / $112.67 / $240.45	Professional	26	$77.25	$112.67	$240.45
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $142.22 / $186.15 / $251.30	Professional		$142.22	$186.15	$251.30
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.69 / $99.11 / $133.80	Professional	26	$69.69	$99.11	$133.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $142.97 / $187.44 / $319.29	Professional		$142.97	$187.44	$319.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.20 / $120.01 / $186.33	Professional	26	$89.20	$120.01	$186.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $294.51 / $445.22 / $445.22	Facility	26	$294.51	$445.22	$445.22
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,391.09 / $3,492.82 / $3,492.82	Professional		$3,391.09	$3,492.82	$3,492.82
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $632.75 / $632.75 / $759.53	Professional	26	$632.75	$632.75	$759.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $111.38	Professional		$32.34	$32.34	$111.38
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.56 / $329.00 / $702.31	Professional		$153.56	$329.00	$702.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $78.06 / $110.31 / $232.71	Professional	26	$78.06	$110.31	$232.71
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $557.09 / $557.09 / $557.09	Professional		$557.09	$557.09	$557.09
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $312.39 / $312.39 / $312.39	Professional	26	$312.39	$312.39	$312.39
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $206.81 / $690.05	Professional		$150.41	$206.81	$690.05
United Facility/Professional Professional Modifier Low / Median / High Price $172.62 / $220.90 / $587.46	Professional		$172.62	$220.90	$587.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.25 / $99.97 / $263.22	Professional	26	$70.25	$99.97	$263.22