Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.68 / $191.89 / $191.89	Facility	26	$181.68	$191.89	$191.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $546.25 / $580.77 / $1,095.44	Professional		$546.25	$580.77	$1,095.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $174.37 / $194.67 / $702.40	Professional	26	$174.37	$194.67	$702.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $812.70 / $1,015.91 / $1,962.19	Professional		$812.70	$1,015.91	$1,962.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $245.02 / $306.32 / $617.17	Professional	26	$245.02	$306.32	$617.17
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $478.60 / $707.35 / $1,702.72	Professional		$478.60	$707.35	$1,702.72
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $157.56 / $226.99 / $560.54	Professional	26	$157.56	$226.99	$560.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $541.40 / $778.54 / $1,804.38	Professional		$541.40	$778.54	$1,804.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $170.76 / $252.32 / $572.29	Professional	26	$170.76	$252.32	$572.29
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $540.76 / $793.67 / $1,071.45	Professional		$540.76	$793.67	$1,071.45
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $167.64 / $231.97 / $313.16	Professional	26	$167.64	$231.97	$313.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $610.95 / $793.67 / $1,509.71	Professional		$610.95	$793.67	$1,509.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $201.43 / $289.95 / $505.69	Professional	26	$201.43	$289.95	$505.69
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $468.94 / $1,008.76 / $1,008.76	Facility	26	$468.94	$1,008.76	$1,008.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,771.72 / $3,771.72 / $5,136.53	Professional		$3,771.72	$3,771.72	$5,136.53
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,240.24 / $1,240.24 / $1,637.25	Professional	26	$1,240.24	$1,240.24	$1,637.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $545.85 / $793.26 / $1,759.48	Professional		$545.85	$793.26	$1,759.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $173.24 / $254.23 / $544.17	Professional	26	$173.24	$254.23	$544.17
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,008.76 / $2,008.76 / $2,008.76	Professional		$2,008.76	$2,008.76	$2,008.76
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $658.93 / $658.93 / $658.93	Professional	26	$658.93	$658.93	$658.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $641.85 / $757.06 / $919.29	Professional		$641.85	$757.06	$919.29
United Facility/Professional Professional Modifier Low / Median / High Price $479.16 / $765.55 / $1,848.39	Professional		$479.16	$765.55	$1,848.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $157.72 / $257.14 / $593.49	Professional	26	$157.72	$257.14	$593.49