Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $113.22 / $512.00	Professional		$63.06	$113.22	$512.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.35 / $31.48 / $158.65	Professional	26	$22.35	$31.48	$158.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.77 / $17.77 / $17.77	Professional	26	$17.77	$17.77	$17.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.54 / $120.72 / $298.75	Professional		$66.54	$120.72	$298.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $48.34 / $111.63	Professional	26	$33.50	$48.34	$111.63
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $124.42 / $302.93	Professional		$94.00	$124.42	$302.93
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $34.47 / $47.97 / $113.37	Professional	26	$34.47	$47.97	$113.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.05 / $80.54 / $281.27	Professional		$54.05	$80.54	$281.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.00 / $22.26 / $72.11	Professional	26	$18.00	$22.26	$72.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $210.96 / $284.80	Professional		$87.98	$210.96	$284.80
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.93 / $56.61 / $70.38	Professional	26	$41.93	$56.61	$70.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.05 / $196.18 / $317.05	Professional		$163.05	$196.18	$317.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $50.32 / $62.91	Professional	26	$33.54	$50.32	$62.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $87.73 / $166.51 / $183.07	Facility	26	$87.73	$166.51	$183.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,357.00 / $1,357.00 / $1,357.00	Professional		$1,357.00	$1,357.00	$1,357.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $271.00 / $271.00 / $293.48	Professional	26	$271.00	$271.00	$293.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $116.39 / $178.94	Professional		$44.63	$116.39	$178.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.08 / $141.04 / $388.68	Professional		$58.08	$141.04	$388.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $23.47 / $98.10	Professional	26	$18.71	$23.47	$98.10
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $524.28 / $524.28 / $524.28	Professional		$524.28	$524.28	$524.28
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	26	$147.91	$147.91	$147.91
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $170.62 / $170.62 / $234.61	Professional		$170.62	$170.62	$234.61
United Facility/Professional Professional Modifier Low / Median / High Price $62.31 / $90.65 / $399.23	Professional		$62.31	$90.65	$399.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $24.41 / $110.02	Professional	26	$21.38	$24.41	$110.02