Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.50 / $66.51 / $395.21	Facility	26	$63.50	$66.51	$395.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.82 / $371.36 / $1,813.66	Professional		$308.82	$371.36	$1,813.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.09 / $66.48 / $332.00	Professional	26	$57.09	$66.48	$332.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $131.96 / $131.96 / $131.96	Professional	26	$131.96	$131.96	$131.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.16 / $413.04 / $937.72	Professional		$293.16	$413.04	$937.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.20 / $87.68 / $188.58	Professional	26	$70.20	$87.68	$188.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $298.52 / $460.40 / $986.91	Professional		$298.52	$460.40	$986.91
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $79.70 / $165.41	Professional	26	$65.98	$79.70	$165.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.67 / $466.85 / $1,099.79	Professional		$287.67	$466.85	$1,099.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.80 / $84.58 / $185.86	Professional	26	$58.80	$84.58	$185.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $182.63 / $438.00 / $591.29	Professional		$182.63	$438.00	$591.29
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.05 / $71.45 / $96.47	Professional	26	$31.05	$71.45	$96.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.77 / $431.64 / $769.18	Professional		$327.77	$431.64	$769.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.75 / $85.62 / $150.12	Professional	26	$58.75	$85.62	$150.12
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $153.81 / $295.52 / $315.45	Facility	26	$153.81	$295.52	$315.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,260.82 / $2,260.82 / $2,789.10	Professional		$2,260.82	$2,260.82	$2,789.10
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $603.00 / $603.00 / $603.00	Professional	26	$603.00	$603.00	$603.00
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 $287.67 / $457.07 / $1,092.28	Professional		$287.67	$457.07	$1,092.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.80 / $85.86 / $183.61	Professional	26	$58.80	$85.86	$183.61
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,249.63 / $1,249.63 / $1,249.63	Professional		$1,249.63	$1,249.63	$1,249.63
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $222.16 / $222.16 / $222.16	Professional	26	$222.16	$222.16	$222.16
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $273.95 / $366.76 / $487.11	Professional		$273.95	$366.76	$487.11
United Facility/Professional Professional Modifier Low / Median / High Price $259.68 / $378.94 / $1,154.65	Professional		$259.68	$378.94	$1,154.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.20 / $76.69 / $216.54	Professional	26	$54.20	$76.69	$216.54