Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $346.74 / $562.34	Facility	26	$181.97	$346.74	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $630.96 / $1,479.11	Professional		$549.54	$630.96	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $213.80 / $707.95	Professional	26	$173.78	$213.80	$707.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,122.02 / $2,187.76	Professional		$831.76	$1,122.02	$2,187.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $338.84 / $660.69	Professional	26	$251.19	$338.84	$660.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $912.01 / $1,995.26	Professional		$616.60	$912.01	$1,995.26
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $302.00 / $660.69	Professional	26	$204.17	$302.00	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $776.25 / $1,659.59	Professional		$537.03	$776.25	$1,659.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $251.19 / $524.81	Professional	26	$169.82	$251.19	$524.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $812.83 / $1,096.48	Professional		$537.03	$812.83	$1,096.48
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $234.42 / $316.23	Professional	26	$165.96	$234.42	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $812.83 / $1,479.11	Professional		$616.60	$812.83	$1,479.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $288.40 / $537.03	Professional	26	$204.17	$288.40	$537.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility	26	$1,230.27	$1,230.27	$1,230.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $5,128.61 / $5,128.61	Professional		$3,801.89	$5,128.61	$5,128.61
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,230.27 / $1,621.81 / $1,621.81	Professional	26	$1,230.27	$1,621.81	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $234.42 / $676.08	Professional		$32.36	$234.42	$676.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $776.25 / $1,621.81	Professional		$524.81	$776.25	$1,621.81
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $251.19 / $512.86	Professional	26	$169.82	$251.19	$512.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Professional	26	$660.69	$660.69	$660.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $741.31 / $912.01	Professional		$537.03	$741.31	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $758.58 / $1,548.82	Professional		$478.63	$758.58	$1,548.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $257.04 / $501.19	Professional	26	$158.49	$257.04	$501.19