Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.70 / $81.62 / $499.89	Facility	26	$78.70	$81.62	$499.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.86 / $102.86 / $102.86	Facility	26	$102.86	$102.86	$102.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $95.38 / $128.76	Professional	26	$34.29	$95.38	$128.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.39 / $115.28 / $179.31	Professional	26	$85.39	$115.28	$179.31
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $710.22 / $710.22 / $725.41	Facility	26	$710.22	$710.22	$725.41
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $102.86 / $102.86 / $102.86	Facility	26	$102.86	$102.86	$102.86