Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $97.72 / $501.19	Facility	26	$75.86	$97.72	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $912.01	Professional		$213.80	$426.58	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $295.12	Professional		$190.55	$257.04	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $602.56	Professional		$190.55	$257.04	$602.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $537.03	Professional		$162.18	$239.88	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $89.13 / $128.82	Facility	26	$19.05	$89.13	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $616.60	Professional		$190.55	$302.00	$616.60
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $346.74 / $467.74	Professional		$81.28	$346.74	$467.74
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $91.20 / $123.03	Professional	26	$22.91	$91.20	$123.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $602.56	Professional		$251.19	$323.59	$602.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $190.55	Professional	26	$81.28	$109.65	$190.55
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	26	$501.19	$501.19	$501.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,137.96 / $2,137.96	Professional		$1,698.24	$2,137.96	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $204.17 / $295.12	Professional		$93.33	$204.17	$295.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $89.13 / $128.82	Facility	26	$19.05	$89.13	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $309.03 / $676.08	Professional		$194.98	$309.03	$676.08
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Professional		$912.01	$912.01	$912.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $323.59	Professional		$123.03	$199.53	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $575.44	Professional		$144.54	$275.42	$575.44