Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.66 / $65.73 / $398.75	Facility	26	$62.66	$65.73	$398.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.87 / $118.54 / $282.88	Professional		$104.87	$118.54	$282.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.95 / $73.39 / $281.12	Professional	26	$58.95	$73.39	$281.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.90 / $175.07 / $439.37	Professional		$105.90	$175.07	$439.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.78 / $94.78 / $245.11	Professional	26	$56.78	$94.78	$245.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $109.73 / $174.77 / $394.08	Professional		$109.73	$174.77	$394.08
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $71.63 / $90.60 / $220.35	Professional	26	$71.63	$90.60	$220.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.55 / $160.38 / $518.73	Professional		$79.55	$160.38	$518.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.70 / $86.06 / $265.24	Professional	26	$57.70	$86.06	$265.24
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.06 / $115.35 / $138.41	Professional		$79.06	$115.35	$138.41
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.93 / $77.11 / $92.53	Professional	26	$56.93	$77.11	$92.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.37 / $128.81 / $226.71	Professional		$97.37	$128.81	$226.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.40 / $96.39 / $177.35	Professional	26	$69.40	$96.39	$177.35
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $158.69 / $305.79 / $336.21	Facility	26	$158.69	$305.79	$336.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,748.00 / $1,748.00 / $1,748.00	Professional		$1,748.00	$1,748.00	$1,748.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $496.08 / $496.08 / $543.29	Professional	26	$496.08	$496.08	$543.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.55 / $181.50 / $422.31	Professional		$79.55	$181.50	$422.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.70 / $85.51 / $192.89	Professional	26	$57.70	$85.51	$192.89
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $307.31 / $307.31 / $307.31	Professional		$307.31	$307.31	$307.31
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $222.51 / $222.51 / $222.51	Professional	26	$222.51	$222.51	$222.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $93.27 / $128.25 / $583.86	Professional		$93.27	$128.25	$583.86
United Facility/Professional Professional Modifier Low / Median / High Price $95.28 / $104.83 / $322.45	Professional		$95.28	$104.83	$322.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.26 / $69.65 / $228.22	Professional	26	$52.26	$69.65	$228.22