Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $263.03 / $562.34	Facility	26	$89.13	$263.03	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $173.78 / $537.03	Professional	26	$91.20	$173.78	$537.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $177.83 / $724.44	Professional	26	$97.72	$177.83	$724.44
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $154.88 / $363.08	Professional	26	$107.15	$154.88	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $109.65 / $263.03	Professional	26	$52.48	$109.65	$263.03
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $112.20 / $302.00	Professional	26	$102.33	$112.20	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $117.49 / $213.80	Professional	26	$87.10	$117.49	$213.80
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,202.26 / $1,202.26 / $1,513.56	Professional	26	$1,202.26	$1,202.26	$1,513.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $107.15 / $257.04	Professional	26	$51.29	$107.15	$257.04
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $302.00 / $302.00	Professional	26	$302.00	$302.00	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $331.13	Professional	26	$81.28	$109.65	$331.13