Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.00 / $90.00 / $265.00	Facility	26	$90.00	$90.00	$265.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $265.00 / $291.50	Professional	26	$90.00	$265.00	$291.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.28 / $113.39 / $225.51	Professional	26	$92.28	$113.39	$225.51
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $99.58 / $107.45 / $314.83	Professional	26	$99.58	$107.45	$314.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.18 / $105.89 / $255.11	Professional	26	$48.18	$105.89	$255.11
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $96.96 / $130.90	Professional	26	$12.01	$96.96	$130.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $79.59 / $115.90 / $203.27	Professional	26	$79.59	$115.90	$203.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $207.94 / $392.09 / $426.88	Facility	26	$207.94	$392.09	$426.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $554.45 / $554.45 / $692.03	Professional	26	$554.45	$554.45	$692.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $48.18 / $105.89 / $249.73	Professional	26	$48.18	$105.89	$249.73
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $300.98 / $300.98 / $300.98	Professional	26	$300.98	$300.98	$300.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $104.01 / $270.27	Professional	26	$74.45	$104.01	$270.27