Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $87.10 / $478.63	Facility	26	$70.79	$87.10	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $204.17 / $489.78	Professional		$147.91	$204.17	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $79.43 / $316.23	Professional	26	$64.57	$79.43	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $199.53	Professional		$134.90	$134.90	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	26	$69.18	$69.18	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $467.74	Professional		$169.82	$223.87	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $100.00 / $199.53	Professional	26	$77.62	$100.00	$199.53
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $239.88 / $489.78	Professional		$165.96	$239.88	$489.78
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $109.65 / $213.80	Professional	26	$79.43	$109.65	$213.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $223.87 / $407.38	Professional		$151.36	$223.87	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $186.21	Professional	26	$66.07	$100.00	$186.21
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $234.42 / $316.23	Professional		$107.15	$234.42	$316.23
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $89.13 / $120.23	Professional	26	$47.86	$89.13	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $389.05	Professional		$173.78	$218.78	$389.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $104.71 / $186.21	Professional	26	$77.62	$104.71	$186.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,445.44 / $1,445.44	Professional		$1,122.02	$1,445.44	$1,445.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $478.63 / $616.60 / $616.60	Professional	26	$478.63	$616.60	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $165.96	Professional		$74.13	$91.20	$165.96
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $457.09	Professional		$151.36	$234.42	$457.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $95.50 / $186.21	Professional	26	$66.07	$95.50	$186.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Professional		$588.84	$588.84	$588.84
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	26	$257.04	$257.04	$257.04
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $213.80 / $263.03	Professional		$162.18	$213.80	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $371.54	Professional		$131.83	$177.83	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $158.49	Professional	26	$56.23	$79.43	$158.49