Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.39 / $29.79 / $180.08	Facility	26	$28.39	$29.79	$180.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.04 / $192.57 / $754.09	Professional		$152.04	$192.57	$754.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.50 / $29.74 / $130.81	Professional	26	$25.50	$29.74	$130.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.60 / $218.93 / $448.35	Professional		$165.60	$218.93	$448.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $41.44 / $84.57	Professional	26	$32.22	$41.44	$84.57
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $156.33 / $229.38 / $482.62	Professional		$156.33	$229.38	$482.62
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.47 / $36.00 / $83.54	Professional	26	$29.47	$36.00	$83.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $227.24 / $596.22	Professional		$146.04	$227.24	$596.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.09 / $37.78 / $84.80	Professional	26	$27.09	$37.78	$84.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $270.54 / $365.23	Professional		$80.91	$270.54	$365.23
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.95 / $32.35 / $43.67	Professional	26	$12.95	$32.35	$43.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $201.37 / $265.43 / $448.27	Professional		$201.37	$265.43	$448.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.59 / $38.69 / $67.87	Professional	26	$26.59	$38.69	$67.87
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $131.69 / $142.79	Facility	26	$85.90	$131.69	$142.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,397.49 / $1,397.49 / $1,711.80	Professional		$1,397.49	$1,397.49	$1,711.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $249.32 / $249.32 / $249.32	Professional	26	$249.32	$249.32	$249.32
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 $146.04 / $224.75 / $536.16	Professional		$146.04	$224.75	$536.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.24 / $38.27 / $84.21	Professional	26	$27.24	$38.27	$84.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $782.16 / $782.16 / $782.16	Professional		$782.16	$782.16	$782.16
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $101.01 / $101.01 / $101.01	Professional	26	$101.01	$101.01	$101.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $121.36 / $197.29 / $300.88	Professional		$121.36	$197.29	$300.88
United Facility/Professional Professional Modifier Low / Median / High Price $124.17 / $229.17 / $709.56	Professional		$124.17	$229.17	$709.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.78 / $34.36 / $90.79	Professional	26	$23.78	$34.36	$90.79