Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $87.10 / $123.03	Facility	26	$43.65	$87.10	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $741.31	Professional		$281.84	$363.08	$741.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $707.95 / $1,174.90	Professional		$478.63	$707.95	$1,174.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $645.65 / $1,202.26	Professional		$446.68	$645.65	$1,202.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $51.29 / $74.13	Facility	26	$10.96	$51.29	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $512.86 / $977.24	Professional		$323.59	$512.86	$977.24
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $645.65	Professional		$346.74	$478.63	$645.65
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $69.18	Professional	26	$38.90	$51.29	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $891.25	Professional		$346.74	$436.52	$891.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $95.50	Professional	26	$45.71	$58.88	$95.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	26	$288.40	$288.40	$288.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,951.21 / $2,951.21	Professional		$2,398.83	$2,951.21	$2,951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $53.70 / $338.84	Professional		$32.36	$53.70	$338.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $51.29 / $74.13	Facility	26	$10.96	$51.29	$74.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $1,000.00	Professional		$323.59	$537.03	$1,000.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $588.84	Professional		$346.74	$457.09	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $891.25	Professional		$323.59	$398.11	$891.25