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 / $504.28	Facility	26	$90.00	$90.00	$504.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $155.00 / $457.86	Professional	26	$90.00	$155.00	$457.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.79 / $136.08 / $251.73	Professional	26	$92.79	$136.08	$251.73
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $88.52 / $102.19 / $252.26	Professional	26	$88.52	$102.19	$252.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.14 / $104.05 / $243.22	Professional	26	$49.14	$104.05	$243.22
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.52 / $92.52 / $124.90	Professional	26	$92.52	$92.52	$124.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.93 / $110.51 / $193.87	Professional	26	$75.93	$110.51	$193.87
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $245.42 / $754.00 / $1,566.00	Facility	26	$245.42	$754.00	$1,566.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,566.00 / $2,660.92 / $2,733.83	Professional	26	$1,566.00	$2,660.92	$2,733.83
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $104.05 / $242.09	Professional	26	$51.25	$104.05	$242.09
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $283.36 / $283.36 / $283.36	Professional	26	$283.36	$283.36	$283.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $106.54 / $275.93	Professional	26	$75.45	$106.54	$275.93