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 / $419.96	Facility	26	$140.00	$140.00	$419.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.52 / $475.00 / $1,420.20	Professional		$192.52	$475.00	$1,420.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.24 / $160.24 / $160.24	Professional		$160.24	$160.24	$160.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.74 / $405.11 / $725.75	Professional		$244.74	$405.11	$725.75
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $187.06 / $289.36 / $698.41	Professional		$187.06	$289.36	$698.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.34 / $78.34 / $78.34	Facility	26	$78.34	$78.34	$78.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.33 / $305.83 / $689.30	Professional		$159.33	$305.83	$689.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $208.80 / $278.01 / $375.31	Professional		$208.80	$278.01	$375.31
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.46 / $75.76 / $102.28	Professional	26	$58.46	$75.76	$102.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $216.61 / $289.83 / $538.02	Professional		$216.61	$289.83	$538.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $94.70 / $400.00	Professional	26	$68.18	$94.70	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $624.08 / $624.08 / $641.60	Facility	26	$624.08	$624.08	$641.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.91 / $1,445.91 / $1,798.50	Professional		$1,445.91	$1,445.91	$1,798.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $164.75	Professional		$32.34	$32.34	$164.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $78.34 / $78.34 / $78.34	Facility	26	$78.34	$78.34	$78.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.77 / $367.43 / $671.85	Professional		$170.77	$367.43	$671.85
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $817.21 / $817.21 / $817.21	Professional		$817.21	$817.21	$817.21
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $224.84 / $292.32 / $354.96	Professional		$224.84	$292.32	$354.96
United Facility/Professional Professional Modifier Low / Median / High Price $211.67 / $460.77 / $1,016.02	Professional		$211.67	$460.77	$1,016.02