Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $93.33 / $407.38	Facility	26	$47.86	$93.33	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $389.05	Professional		$112.20	$154.88	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $131.83	Professional		$100.00	$104.71	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $416.87	Professional		$138.04	$194.98	$416.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $398.11	Professional		$141.25	$208.93	$398.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $77.62 / $112.20	Facility	26	$16.60	$77.62	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $323.59	Professional		$112.20	$173.78	$323.59
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $229.09	Professional		$93.33	$169.82	$229.09
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $75.86 / $102.33	Professional	26	$33.88	$75.86	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $275.42	Professional		$125.89	$162.18	$275.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $87.10 / $141.25	Professional	26	$67.61	$87.10	$141.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Professional		$1,202.26	$1,202.26	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $154.88	Professional		$32.36	$60.26	$154.88
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $77.62 / $112.20	Facility	26	$16.60	$77.62	$112.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $338.84	Professional		$112.20	$177.83	$338.84
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $173.78 / $229.09	Professional		$138.04	$173.78	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $275.42	Professional		$102.33	$138.04	$275.42