Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $91.20 / $229.09	Facility	26	$46.77	$91.20	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $524.81	Professional		$48.98	$102.33	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $131.83	Professional	26	$30.20	$46.77	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $223.87	Professional		$91.20	$131.83	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $114.82	Professional	26	$47.86	$63.10	$114.82
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $120.23 / $323.59	Professional	50	$91.20	$120.23	$323.59
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $229.09	Professional		$87.10	$125.89	$229.09
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $64.57 / $120.23	Professional	26	$44.67	$64.57	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	26	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $117.49 / $204.17	Professional		$56.23	$117.49	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $58.88 / $102.33	Professional	26	$33.11	$58.88	$102.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $74.13 / $100.00	Professional		$51.29	$74.13	$100.00
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $42.66 / $57.54	Professional	26	$26.30	$42.66	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $138.04	Professional		$54.95	$70.79	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $48.98 / $87.10	Professional	26	$36.31	$48.98	$87.10
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Professional		$724.44	$724.44	$724.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $302.00 / $302.00	Professional	26	$302.00	$302.00	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $47.86 / $95.50	Professional		$42.66	$47.86	$95.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	26	$8.51	$39.81	$56.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $120.23 / $194.98	Professional		$56.23	$120.23	$194.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $57.54 / $102.33	Professional	26	$32.36	$57.54	$102.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	26	$117.49	$117.49	$117.49
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $134.90	Professional		$60.26	$83.18	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $165.96	Professional		$56.23	$79.43	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $81.28	Professional	26	$33.11	$39.81	$81.28