Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $33.97 / $195.47	Facility	26	$32.40	$33.97	$195.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.80 / $126.34 / $285.94	Professional		$100.80	$126.34	$285.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $39.04 / $101.08	Professional	26	$30.51	$39.04	$101.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.61 / $37.61 / $41.37	Professional	26	$37.61	$37.61	$41.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.88 / $144.69 / $317.75	Professional		$97.88	$144.69	$317.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.02 / $51.82 / $128.47	Professional	26	$34.02	$51.82	$128.47
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $135.26 / $322.48	Professional		$100.00	$135.26	$322.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $37.75 / $100.00	Professional	26	$31.24	$37.75	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.06 / $56.06 / $56.06	Facility	26	$56.06	$56.06	$56.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.24 / $138.71 / $313.39	Professional		$89.24	$138.71	$313.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.69 / $46.41 / $103.05	Professional	26	$32.69	$46.41	$103.05
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $132.19 / $178.47	Professional		$61.12	$132.19	$178.47
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $52.65 / $71.08	Professional	26	$17.11	$52.65	$71.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.90 / $132.19 / $222.23	Professional		$98.90	$132.19	$222.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.02 / $63.48 / $98.98	Professional	26	$47.02	$63.48	$98.98
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $114.26 / $234.22 / $234.22	Facility	26	$114.26	$234.22	$234.22
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $803.00 / $803.00 / $883.28	Professional		$803.00	$803.00	$883.28
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $310.62 / $310.62 / $389.93	Professional	26	$310.62	$310.62	$389.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $58.61	Professional		$32.34	$32.34	$58.61
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $56.06 / $56.06 / $56.06	Facility	26	$56.06	$56.06	$56.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.99 / $155.29 / $300.95	Professional		$91.99	$155.29	$300.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $45.01 / $95.12	Professional	26	$32.25	$45.01	$95.12
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $358.05 / $358.05 / $358.05	Professional		$358.05	$358.05	$358.05
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $110.96 / $110.96 / $110.96	Professional	26	$110.96	$110.96	$110.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $91.68 / $122.74 / $149.04	Professional		$91.68	$122.74	$149.04
United Facility/Professional Professional Modifier Low / Median / High Price $83.11 / $122.02 / $288.42	Professional		$83.11	$122.02	$288.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.66 / $38.90 / $96.71	Professional	26	$27.66	$38.90	$96.71