Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.23 / $54.65 / $316.02	Facility	26	$52.23	$54.65	$316.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.30 / $59.30 / $59.30	Facility	26	$59.30	$59.30	$59.30
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.59 / $62.25 / $76.40	Professional	26	$56.59	$62.25	$76.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.50 / $68.18 / $106.39	Professional	26	$50.50	$68.18	$106.39
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $251.23 / $251.23	Facility	26	$123.03	$251.23	$251.23
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $59.30 / $59.30 / $59.30	Facility	26	$59.30	$59.30	$59.30