Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.33 / $29.13 / $138.05	Facility	26	$27.33	$29.13	$138.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.07 / $71.58 / $278.70	Professional		$42.07	$71.58	$278.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.64 / $27.32 / $131.35	Professional	26	$19.64	$27.32	$131.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.77 / $81.77 / $81.77	Professional		$81.77	$81.77	$81.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $95.26 / $170.76	Professional		$68.75	$95.26	$170.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.98 / $38.09 / $71.12	Professional	26	$29.98	$38.09	$71.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $56.11 / $73.45 / $175.29	Professional		$56.11	$73.45	$175.29
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.47 / $29.93 / $81.23	Professional	26	$23.47	$29.93	$81.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.10 / $25.10 / $25.10	Facility	26	$25.10	$25.10	$25.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $89.73 / $182.87	Professional		$50.13	$89.73	$182.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $34.67 / $73.26	Professional	26	$23.14	$34.67	$73.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.29 / $59.35 / $80.12	Professional		$42.29	$59.35	$80.12
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $26.16 / $35.32	Professional	26	$16.07	$26.16	$35.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.52 / $60.47 / $113.92	Professional		$46.52	$60.47	$113.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.49 / $32.17 / $54.07	Professional	26	$22.49	$32.17	$54.07
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $51.64 / $113.10 / $113.10	Facility	26	$51.64	$113.10	$113.10
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $497.00 / $497.00 / $497.00	Professional		$497.00	$497.00	$497.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $320.31 / $320.31 / $320.31	Professional	26	$320.31	$320.31	$320.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $41.98	Professional		$32.34	$32.34	$41.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $25.10 / $25.10 / $25.10	Facility	26	$25.10	$25.10	$25.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.48 / $93.33 / $160.19	Professional		$54.48	$93.33	$160.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $34.24 / $70.00	Professional	26	$23.14	$34.24	$70.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $160.37 / $160.37 / $160.37	Professional		$160.37	$160.37	$160.37
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $75.56 / $75.56 / $75.56	Professional	26	$75.56	$75.56	$75.56
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $65.98 / $133.66	Professional		$47.99	$65.98	$133.66
United Facility/Professional Professional Modifier Low / Median / High Price $49.08 / $58.06 / $143.60	Professional		$49.08	$58.06	$143.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $24.83 / $62.10	Professional	26	$19.89	$24.83	$62.10