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 / $609.40	Facility	26	$140.00	$140.00	$609.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.32 / $475.00 / $1,738.40	Professional		$316.32	$475.00	$1,738.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $481.24 / $481.24 / $615.03	Professional		$481.24	$481.24	$615.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.48 / $639.28 / $1,153.33	Professional		$386.48	$639.28	$1,153.33
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $297.43 / $460.61 / $1,110.48	Professional		$297.43	$460.61	$1,110.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.82 / $113.82 / $113.82	Facility	26	$113.82	$113.82	$113.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.34 / $476.01 / $1,097.68	Professional		$254.34	$476.01	$1,097.68
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $331.54 / $441.88 / $596.54	Professional		$331.54	$441.88	$596.54
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.89 / $110.52 / $149.19	Professional	26	$82.89	$110.52	$149.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $333.87 / $442.59 / $853.23	Professional		$333.87	$442.59	$853.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $99.47 / $138.15 / $400.00	Professional	26	$99.47	$138.15	$400.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $913.76 / $913.76 / $931.68	Facility	26	$913.76	$913.76	$931.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,291.23 / $2,291.23 / $2,857.28	Professional		$2,291.23	$2,291.23	$2,857.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $271.41	Professional		$32.34	$32.34	$271.41
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $113.82 / $113.82 / $113.82	Facility	26	$113.82	$113.82	$113.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $272.68 / $550.66 / $1,059.34	Professional		$272.68	$550.66	$1,059.34
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,297.30 / $1,297.30 / $1,297.30	Professional		$1,297.30	$1,297.30	$1,297.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $357.36 / $464.15 / $563.61	Professional		$357.36	$464.15	$563.61
United Facility/Professional Professional Modifier Low / Median / High Price $335.29 / $577.01 / $1,254.21	Professional		$335.29	$577.01	$1,254.21