Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $63.10 / $295.12	Facility	26	$32.36	$63.10	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $309.03	Professional		$95.50	$131.83	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $47.86 / $131.83	Professional	26	$31.62	$47.86	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $47.86 / $91.20	Professional	26	$38.02	$47.86	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $346.74	Professional		$104.71	$154.88	$346.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $63.10 / $138.04	Professional	26	$36.31	$63.10	$138.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $331.13	Professional		$117.49	$173.78	$331.13
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.98 / $104.71	Professional	26	$34.67	$48.98	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $275.42	Professional		$87.10	$141.25	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $95.50	Professional	26	$32.36	$46.77	$95.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $138.04 / $186.21	Professional		$61.66	$138.04	$186.21
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $54.95 / $74.13	Professional	26	$16.98	$54.95	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $223.87	Professional		$102.33	$131.83	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $63.10 / $102.33	Professional	26	$48.98	$63.10	$102.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $891.25 / $891.25	Professional		$794.33	$891.25	$891.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $389.05 / $389.05	Professional	26	$309.03	$389.05	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $125.89	Professional		$32.36	$54.95	$125.89
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $281.84	Professional		$89.13	$144.54	$281.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $91.20	Professional	26	$30.20	$43.65	$91.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Professional	26	$112.20	$112.20	$112.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $154.88	Professional		$91.20	$123.03	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $229.09	Professional		$79.43	$112.20	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $75.86	Professional	26	$27.54	$35.48	$75.86