Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $358.38 / $604.78 / $1,936.15	Professional		$358.38	$604.78	$1,936.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.94 / $71.43 / $327.64	Professional	26	$52.94	$71.43	$327.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $126.62 / $126.62 / $370.00	Professional	26	$126.62	$126.62	$370.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.02 / $710.28 / $1,429.22	Professional		$181.02	$710.28	$1,429.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $109.24 / $222.56	Professional	26	$70.48	$109.24	$222.56
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $445.34 / $636.20 / $1,467.04	Professional		$445.34	$636.20	$1,467.04
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.40 / $67.36 / $155.83	Professional	26	$47.40	$67.36	$155.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.39 / $365.03 / $1,080.18	Professional		$187.39	$365.03	$1,080.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $45.66 / $150.49	Professional	26	$38.26	$45.66	$150.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $237.71 / $657.22 / $887.25	Professional		$237.71	$657.22	$887.25
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.16 / $116.32 / $190.17	Professional	26	$86.16	$116.32	$190.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.11 / $594.70 / $985.83	Professional		$489.11	$594.70	$985.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.93 / $103.39 / $129.29	Professional	26	$68.93	$103.39	$129.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $183.39 / $340.61 / $375.20	Facility	26	$183.39	$340.61	$375.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,261.22 / $3,261.22 / $4,153.64	Professional		$3,261.22	$3,261.22	$4,153.64
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $665.00 / $665.00 / $665.00	Professional	26	$665.00	$665.00	$665.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.40 / $435.89 / $524.29	Professional		$88.40	$435.89	$524.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $198.03 / $571.61 / $1,300.52	Professional		$198.03	$571.61	$1,300.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.35 / $47.95 / $200.72	Professional	26	$38.35	$47.95	$200.72
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,477.52 / $1,477.52 / $1,477.52	Professional		$1,477.52	$1,477.52	$1,477.52
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $291.91 / $291.91 / $291.91	Professional	26	$291.91	$291.91	$291.91
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $531.59 / $531.59 / $730.94	Professional		$531.59	$531.59	$730.94
United Facility/Professional Professional Modifier Low / Median / High Price $236.46 / $379.20 / $1,128.21	Professional		$236.46	$379.20	$1,128.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.66 / $49.60 / $175.47	Professional	26	$43.66	$49.60	$175.47