Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.03 / $38.85 / $225.20	Facility	26	$36.03	$38.85	$225.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.37 / $203.42 / $1,408.00	Professional		$149.37	$203.42	$1,408.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $38.85 / $205.00	Professional	26	$34.65	$38.85	$205.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.61 / $230.32 / $525.26	Professional		$168.61	$230.32	$525.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.70 / $54.48 / $108.29	Professional	26	$38.70	$54.48	$108.29
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $246.85 / $352.64 / $579.42	Professional		$246.85	$352.64	$579.42
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $45.39 / $100.00	Professional	26	$38.58	$45.39	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.74 / $308.89 / $860.67	Professional		$175.74	$308.89	$860.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $48.95 / $107.48	Professional	26	$34.29	$48.95	$107.48
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $96.11 / $353.36 / $477.04	Professional		$96.11	$353.36	$477.04
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.53 / $41.58 / $56.13	Professional	26	$11.53	$41.58	$56.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $262.98 / $346.63 / $548.00	Professional		$262.98	$346.63	$548.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.19 / $49.76 / $87.29	Professional	26	$34.19	$49.76	$87.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $98.17 / $172.44 / $183.68	Facility	26	$98.17	$172.44	$183.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,791.90 / $1,791.90 / $2,235.90	Professional		$1,791.90	$1,791.90	$2,235.90
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $258.60 / $258.60 / $301.95	Professional	26	$258.60	$258.60	$301.95
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 $175.74 / $291.39 / $860.67	Professional		$175.74	$291.39	$860.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $48.99 / $106.75	Professional	26	$34.29	$48.99	$106.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,010.96 / $1,010.96 / $1,010.96	Professional		$1,010.96	$1,010.96	$1,010.96
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $126.55 / $126.55 / $126.55	Professional	26	$126.55	$126.55	$126.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $144.16 / $234.37 / $392.99	Professional		$144.16	$234.37	$392.99
United Facility/Professional Professional Modifier Low / Median / High Price $138.97 / $276.62 / $935.85	Professional		$138.97	$276.62	$935.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $44.34 / $106.68	Professional	26	$31.53	$44.34	$106.68