Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.78 / $75.36 / $459.51	Facility	26	$71.78	$75.36	$459.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.55 / $188.48 / $503.41	Professional		$155.55	$188.48	$503.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $75.36 / $347.22	Professional	26	$67.59	$75.36	$347.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.80 / $171.80 / $171.80	Professional		$171.80	$171.80	$171.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.88 / $55.88 / $55.88	Professional	26	$55.88	$55.88	$55.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.18 / $216.72 / $455.36	Professional		$171.18	$216.72	$455.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.28 / $97.10 / $197.68	Professional	26	$76.28	$97.10	$197.68
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $121.09 / $182.50 / $445.26	Professional		$121.09	$182.50	$445.26
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.23 / $88.88 / $207.70	Professional	26	$72.23	$88.88	$207.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $86.87 / $86.87	Facility	26	$86.87	$86.87	$86.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.26 / $226.42 / $510.18	Professional		$150.26	$226.42	$510.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.31 / $99.14 / $211.71	Professional	26	$67.31	$99.14	$211.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $107.95 / $221.71 / $299.31	Professional		$107.95	$221.71	$299.31
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.50 / $86.02 / $116.13	Professional	26	$47.50	$86.02	$116.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.07 / $226.16 / $390.33	Professional		$173.07	$226.16	$390.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.43 / $106.79 / $179.63	Professional	26	$75.43	$106.79	$179.63
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $179.26 / $343.65 / $376.39	Facility	26	$179.26	$343.65	$376.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,115.94 / $1,115.94 / $1,452.60	Professional		$1,115.94	$1,115.94	$1,452.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $476.34 / $476.34 / $610.04	Professional	26	$476.34	$476.34	$610.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $90.96	Professional		$32.34	$32.34	$90.96
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $86.87 / $86.87	Facility	26	$86.87	$86.87	$86.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $154.90 / $243.13 / $486.62	Professional		$154.90	$243.13	$486.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.31 / $95.55 / $209.51	Professional	26	$67.31	$95.55	$209.51
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $585.15 / $585.15 / $585.15	Professional		$585.15	$585.15	$585.15
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $256.32 / $256.32 / $256.32	Professional	26	$256.32	$256.32	$256.32
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $161.93 / $216.79 / $263.24	Professional		$161.93	$216.79	$263.24
United Facility/Professional Professional Modifier Low / Median / High Price $131.02 / $179.00 / $523.70	Professional		$131.02	$179.00	$523.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.99 / $80.12 / $209.77	Professional	26	$55.99	$80.12	$209.77