Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.59 / $91.29 / $553.33	Facility	26	$86.59	$91.29	$553.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.43 / $329.88 / $1,087.64	Professional		$173.43	$329.88	$1,087.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $102.20 / $406.34	Professional	26	$81.76	$102.20	$406.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.73 / $214.48 / $427.01	Professional		$165.73	$214.48	$427.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.11 / $170.43 / $405.00	Professional	26	$75.11	$170.43	$405.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.49 / $275.41 / $515.30	Professional		$204.49	$275.41	$515.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.32 / $126.61 / $250.29	Professional	26	$99.32	$126.61	$250.29
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $155.81 / $253.71 / $620.87	Professional		$155.81	$253.71	$620.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.11 / $117.38 / $290.18	Professional	26	$97.11	$117.38	$290.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.53 / $258.44 / $516.45	Professional		$160.53	$258.44	$516.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.91 / $120.04 / $264.27	Professional	26	$82.91	$120.04	$264.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $158.68 / $221.64 / $299.20	Professional		$158.68	$221.64	$299.20
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.93 / $100.95 / $136.28	Professional	26	$80.93	$100.95	$136.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.63 / $228.05 / $437.18	Professional		$169.63	$228.05	$437.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $88.85 / $125.46 / $211.09	Professional	26	$88.85	$125.46	$211.09
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.26 / $404.21 / $442.37	Facility	26	$213.26	$404.21	$442.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,463.47 / $1,466.63 / $1,511.77	Professional		$1,463.47	$1,466.63	$1,511.77
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $605.95 / $625.94 / $713.48	Professional	26	$605.95	$625.94	$713.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $169.55	Professional		$32.34	$32.34	$169.55
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $163.79 / $279.63 / $511.02	Professional		$163.79	$279.63	$511.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $83.14 / $117.60 / $261.26	Professional	26	$83.14	$117.60	$261.26
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $588.29 / $588.29 / $588.29	Professional		$588.29	$588.29	$588.29
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $309.30 / $309.30 / $309.30	Professional	26	$309.30	$309.30	$309.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $179.24 / $222.16 / $269.76	Professional		$179.24	$222.16	$269.76
United Facility/Professional Professional Modifier Low / Median / High Price $144.36 / $187.35 / $489.00	Professional		$144.36	$187.35	$489.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $96.72 / $266.68	Professional	26	$67.70	$96.72	$266.68