Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.43 / $54.78 / $559.95	Facility	26	$52.43	$54.78	$559.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $233.74 / $419.56	Professional		$150.69	$233.74	$419.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.34 / $76.15 / $279.62	Professional	26	$49.34	$76.15	$279.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.47 / $174.80 / $195.00	Professional	26	$73.47	$174.80	$195.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.39 / $304.16 / $682.86	Professional		$188.39	$304.16	$682.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.44 / $87.23 / $273.48	Professional	26	$55.44	$87.23	$273.48
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $276.72 / $625.08	Professional		$167.09	$276.72	$625.08
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $50.15 / $60.54 / $150.76	Professional	26	$50.15	$60.54	$150.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $287.27 / $700.86	Professional		$137.72	$287.27	$700.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.79 / $80.86 / $214.45	Professional	26	$55.79	$80.86	$214.45
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $130.26 / $207.39 / $279.98	Professional		$130.26	$207.39	$279.98
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.59 / $101.53 / $137.07	Professional	26	$45.59	$101.53	$137.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.15 / $209.53 / $352.83	Professional		$157.15	$209.53	$352.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.00 / $122.85 / $190.88	Professional	26	$91.00	$122.85	$190.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $221.69 / $453.39 / $453.39	Facility	26	$221.69	$453.39	$453.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,093.52 / $3,186.33 / $3,186.33	Professional		$3,093.52	$3,186.33	$3,186.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $676.01 / $676.01 / $760.80	Professional	26	$676.01	$676.01	$760.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $112.72	Professional		$32.34	$32.34	$112.72
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.26 / $321.69 / $626.91	Professional		$151.26	$321.69	$626.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.73 / $79.31 / $188.17	Professional	26	$56.73	$79.31	$188.17
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $607.61 / $607.61 / $607.61	Professional		$607.61	$607.61	$607.61
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $317.24 / $317.24 / $317.24	Professional	26	$317.24	$317.24	$317.24
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $167.62 / $230.48 / $629.69	Professional		$167.62	$230.48	$629.69
United Facility/Professional Professional Modifier Low / Median / High Price $176.80 / $243.97 / $591.66	Professional		$176.80	$243.97	$591.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.80 / $100.33 / $235.27	Professional	26	$44.80	$100.33	$235.27