Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $100.00 / $309.03	Facility	26	$51.29	$100.00	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $204.17 / $426.58	Professional		$100.00	$204.17	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $112.20	Professional		$87.10	$91.20	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $302.00 / $645.65	Professional		$138.04	$302.00	$645.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $549.54	Professional		$218.78	$309.03	$549.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $61.66 / $87.10	Facility	26	$13.18	$61.66	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $218.78 / $616.60	Professional		$104.71	$218.78	$616.60
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $194.98	Professional		$104.71	$144.54	$194.98
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $57.54 / $77.62	Professional	26	$40.74	$57.54	$77.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $138.04 / $257.04	Professional		$109.65	$138.04	$257.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $107.15	Professional	26	$51.29	$67.61	$107.15
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $63.10 / $131.83	Professional		$32.36	$63.10	$131.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $61.66 / $87.10	Facility	26	$13.18	$61.66	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $223.87 / $602.56	Professional		$107.15	$223.87	$602.56
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 $117.49 / $162.18 / $630.96	Professional		$117.49	$162.18	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $467.74	Professional		$117.49	$165.96	$467.74