Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.99 / $105.34 / $645.55	Facility	26	$99.99	$105.34	$645.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.86 / $131.86 / $131.86	Facility	26	$131.86	$131.86	$131.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.00 / $122.96 / $166.00	Professional	26	$93.00	$122.96	$166.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $110.42 / $148.63 / $231.16	Professional	26	$110.42	$148.63	$231.16
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $260.70 / $556.61 / $556.61	Facility	26	$260.70	$556.61	$556.61
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $131.86 / $131.86 / $131.86	Facility	26	$131.86	$131.86	$131.86