Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.73 / $53.97 / $308.06	Facility	26	$51.73	$53.97	$308.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $207.31 / $391.04	Professional		$106.50	$207.31	$391.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.68 / $117.68 / $117.68	Professional		$117.68	$117.68	$117.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $270.83 / $618.66	Professional		$128.13	$270.83	$618.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $151.47 / $246.14 / $544.01	Professional		$151.47	$246.14	$544.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.80 / $60.80 / $60.80	Facility	26	$60.80	$60.80	$60.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.56 / $228.40 / $669.34	Professional		$109.56	$228.40	$669.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $103.52 / $139.72 / $188.64	Professional		$103.52	$139.72	$188.64
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $56.05 / $75.67	Professional	26	$40.36	$56.05	$75.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.77 / $140.35 / $247.30	Professional		$107.77	$140.35	$247.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.45 / $67.84 / $105.37	Professional	26	$50.45	$67.84	$105.37
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $123.61 / $253.46 / $253.46	Facility	26	$123.61	$253.46	$253.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,401.00 / $3,401.00 / $3,401.00	Professional		$3,401.00	$3,401.00	$3,401.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $69.72	Professional		$32.34	$32.34	$69.72
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $60.80 / $60.80 / $60.80	Facility	26	$60.80	$60.80	$60.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $115.24 / $246.50 / $602.07	Professional		$115.24	$246.50	$602.07
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $413.82 / $413.82 / $413.82	Professional		$413.82	$413.82	$413.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $112.91 / $155.25 / $629.69	Professional		$112.91	$155.25	$629.69
United Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $167.03 / $481.54	Professional		$128.12	$167.03	$481.54