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 / $538.49	Facility	26	$90.00	$90.00	$538.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $139.71 / $418.38	Professional	26	$90.00	$139.71	$418.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.56 / $141.35 / $638.76	Professional	26	$89.56	$141.35	$638.76
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.60 / $307.98	Professional	26	$100.00	$117.60	$307.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.91 / $109.65 / $260.37	Professional	26	$51.91	$109.65	$260.37
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $135.00 / $304.05	Professional	26	$100.00	$135.00	$304.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.38 / $120.00 / $210.52	Professional	26	$82.38	$120.00	$210.52
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $830.48 / $830.48 / $960.00	Facility	26	$830.48	$830.48	$960.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,192.32 / $1,463.88 / $1,503.99	Professional	26	$1,192.32	$1,463.88	$1,503.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $51.91 / $109.09 / $260.37	Professional	26	$51.91	$109.09	$260.37
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $303.99 / $303.99 / $303.99	Professional	26	$303.99	$303.99	$303.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.98 / $102.79 / $349.63	Professional	26	$80.98	$102.79	$349.63