Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $521.65 / $547.23 / $2,738.00	Facility	26	$521.65	$547.23	$2,738.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $740.75 / $851.91 / $2,235.48	Professional		$740.75	$851.91	$2,235.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $491.36 / $546.23 / $1,272.47	Professional	26	$491.36	$546.23	$1,272.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $848.43 / $1,075.65 / $2,233.58	Professional		$848.43	$1,075.65	$2,233.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $594.54 / $744.77 / $1,418.52	Professional	26	$594.54	$744.77	$1,418.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $628.45 / $913.66 / $2,227.23	Professional		$628.45	$913.66	$2,227.23
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $459.93 / $660.24 / $1,582.36	Professional	26	$459.93	$660.24	$1,582.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $742.25 / $1,037.79 / $2,455.31	Professional		$742.25	$1,037.79	$2,455.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $481.29 / $647.99 / $1,466.67	Professional	26	$481.29	$647.99	$1,466.67
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $734.59 / $1,176.93 / $1,588.86	Professional		$734.59	$1,176.93	$1,588.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $389.33 / $534.32 / $721.33	Professional	26	$389.33	$534.32	$721.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $917.87 / $1,189.59 / $2,125.44	Professional		$917.87	$1,189.59	$2,125.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $464.21 / $667.90 / $1,110.99	Professional	26	$464.21	$667.90	$1,110.99
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3,401.60 / $4,284.56 / $4,331.35	Facility	26	$3,401.60	$4,284.56	$4,331.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,280.00 / $6,280.00 / $7,786.43	Professional		$6,280.00	$6,280.00	$7,786.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5,024.00 / $5,024.00 / $5,024.00	Professional	26	$5,024.00	$5,024.00	$5,024.00
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 $763.58 / $1,070.05 / $2,396.30	Professional		$763.58	$1,070.05	$2,396.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $481.29 / $653.70 / $1,466.67	Professional	26	$481.29	$653.70	$1,466.67
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $2,883.43 / $2,883.43 / $2,883.43	Professional		$2,883.43	$2,883.43	$2,883.43
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $1,518.99 / $1,518.99 / $1,518.99	Professional	26	$1,518.99	$1,518.99	$1,518.99
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $951.68 / $1,308.56 / $2,608.19	Professional		$951.68	$1,308.56	$2,608.19
United Facility/Professional Professional Modifier Low / Median / High Price $633.57 / $1,107.95 / $2,958.52	Professional		$633.57	$1,107.95	$2,958.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $435.16 / $593.23 / $1,450.30	Professional	26	$435.16	$593.23	$1,450.30