Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $112.20 / $251.19	Facility	26	$83.18	$112.20	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $144.54 / $363.08	Professional		$60.26	$144.54	$363.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $302.00 / $302.00 / $446.68	Professional	50	$302.00	$302.00	$446.68
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	50	$85.11	$85.11	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $354.81	Professional		$138.04	$223.87	$354.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.65 / $190.55 / $478.63	Professional	50	$109.65	$190.55	$478.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $234.42 / $426.58	Professional		$165.96	$234.42	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	26	$9.33	$43.65	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $173.78 / $295.12	Professional		$75.86	$173.78	$295.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $120.23	Professional		$63.10	$89.13	$120.23
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $63.10	Professional	26	$32.36	$46.77	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $194.98	Professional		$66.07	$85.11	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $53.70 / $95.50	Professional	26	$39.81	$53.70	$95.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Professional		$912.01	$912.01	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $74.13 / $162.18	Professional		$67.61	$74.13	$162.18
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	26	$9.33	$43.65	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $169.82 / $288.40	Professional		$74.13	$169.82	$288.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $107.15	Professional		$63.10	$81.28	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $245.47	Professional		$75.86	$117.49	$245.47