Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.46 / $59.63 / $329.38	Facility	26	$53.46	$59.63	$329.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.83 / $252.82 / $638.39	Professional		$225.83	$252.82	$638.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.39 / $56.63 / $148.61	Professional	26	$47.39	$56.63	$148.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.74 / $379.12 / $714.02	Professional		$213.74	$379.12	$714.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.26 / $88.59 / $156.41	Professional	26	$54.26	$88.59	$156.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $184.77 / $269.19 / $654.60	Professional		$184.77	$269.19	$654.60
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $49.15 / $64.51 / $149.77	Professional	26	$49.15	$64.51	$149.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.41 / $60.41 / $60.41	Facility	26	$60.41	$60.41	$60.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.84 / $319.08 / $694.19	Professional		$233.84	$319.08	$694.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.14 / $71.64 / $150.79	Professional	26	$55.14	$71.64	$150.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $207.76 / $434.71 / $586.86	Professional		$207.76	$434.71	$586.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.78 / $62.32 / $84.13	Professional	26	$47.78	$62.32	$84.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.05 / $423.95 / $673.80	Professional		$323.05	$423.95	$673.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.62 / $74.78 / $117.16	Professional	26	$53.62	$74.78	$117.16
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $122.35 / $268.99 / $268.99	Facility	26	$122.35	$268.99	$268.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.46 / $1,659.46 / $2,730.98	Professional		$1,659.46	$1,659.46	$2,730.98
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $337.70 / $337.70 / $432.90	Professional	26	$337.70	$337.70	$432.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $305.18	Professional		$32.34	$32.34	$305.18
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $60.41 / $60.41 / $60.41	Facility	26	$60.41	$60.41	$60.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.73 / $377.94 / $694.19	Professional		$245.73	$377.94	$694.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $55.64 / $71.47 / $148.65	Professional	26	$55.64	$71.47	$148.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $800.76 / $800.76 / $800.76	Professional		$800.76	$800.76	$800.76
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $179.80 / $179.80 / $179.80	Professional	26	$179.80	$179.80	$179.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $270.08 / $361.51 / $483.53	Professional		$270.08	$361.51	$483.53
United Facility/Professional Professional Modifier Low / Median / High Price $185.09 / $275.11 / $687.42	Professional		$185.09	$275.11	$687.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.12 / $60.51 / $135.31	Professional	26	$43.12	$60.51	$135.31