Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $147.91 / $457.09	Facility	26	$75.86	$147.91	$457.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $83.18 / $112.20	Professional	26	$61.66	$83.18	$112.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $97.72 / $158.49	Professional	26	$75.86	$97.72	$158.49
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89