Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.00 / $140.00 / $423.40	Facility	26	$140.00	$140.00	$423.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $522.50 / $1,376.25	Professional		$475.00	$522.50	$1,376.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.20 / $140.00 / $312.89	Professional	26	$108.20	$140.00	$312.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.91 / $583.79 / $1,396.55	Professional		$346.91	$583.79	$1,396.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.79 / $102.97 / $203.69	Professional	26	$61.79	$102.97	$203.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $335.40 / $517.25 / $1,347.41	Professional		$335.40	$517.25	$1,347.41
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.18 / $91.60 / $234.78	Professional	26	$72.18	$91.60	$234.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $377.95 / $611.17 / $1,638.36	Professional		$377.95	$611.17	$1,638.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.11 / $92.46 / $293.73	Professional	26	$63.11	$92.46	$293.73
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $366.76 / $553.79 / $664.55	Professional		$366.76	$553.79	$664.55
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.35 / $78.75 / $94.50	Professional	26	$62.35	$78.75	$94.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.14 / $1,040.45	Professional		$436.52	$588.14	$1,040.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.88 / $98.44 / $177.19	Professional	26	$70.88	$98.44	$177.19
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $512.00 / $646.48 / $661.44	Facility	26	$512.00	$646.48	$661.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,775.50 / $2,775.50 / $3,500.18	Professional		$2,775.50	$2,775.50	$3,500.18
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $439.61 / $439.61 / $563.25	Professional	26	$439.61	$439.61	$563.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $398.57 / $618.51 / $1,434.75	Professional		$398.57	$618.51	$1,434.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.91 / $92.06 / $214.93	Professional	26	$63.91	$92.06	$214.93
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,562.84 / $1,562.84 / $1,562.84	Professional		$1,562.84	$1,562.84	$1,562.84
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $237.98 / $237.98 / $237.98	Professional	26	$237.98	$237.98	$237.98
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $366.76 / $513.46 / $623.49	Professional		$366.76	$513.46	$623.49
United Facility/Professional Professional Modifier Low / Median / High Price $345.42 / $401.85 / $1,573.29	Professional		$345.42	$401.85	$1,573.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.60 / $63.50 / $252.83	Professional	26	$55.60	$63.50	$252.83