Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.45 / $47.24 / $267.68	Facility	26	$43.45	$47.24	$267.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.68 / $66.12 / $108.65	Professional		$53.68	$66.12	$108.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.45 / $46.31 / $70.61	Professional	26	$38.45	$46.31	$70.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $71.17 / $145.38	Professional		$56.98	$71.17	$145.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $49.57 / $101.26	Professional	26	$40.47	$49.57	$101.26
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $54.15 / $74.88 / $174.23	Professional		$54.15	$74.88	$174.23
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $51.83 / $120.47	Professional	26	$36.95	$51.83	$120.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.97 / $86.12 / $191.24	Professional		$65.97	$86.12	$191.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.43 / $59.54 / $132.33	Professional	26	$46.43	$59.54	$132.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.09 / $87.01 / $106.79	Professional		$79.09	$87.01	$106.79
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.42 / $56.56 / $69.42	Professional	26	$51.42	$56.56	$69.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.85 / $79.09 / $142.81	Professional		$61.85	$79.09	$142.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.32 / $51.42 / $87.41	Professional	26	$42.32	$51.42	$87.41
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $104.07 / $201.33 / $222.92	Facility	26	$104.07	$201.33	$222.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $404.18 / $404.18 / $529.79	Professional		$404.18	$404.18	$529.79
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $278.89 / $278.89 / $356.10	Professional	26	$278.89	$278.89	$356.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.15 / $97.35 / $172.22	Professional		$67.15	$97.35	$172.22
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $46.87 / $59.87 / $122.07	Professional	26	$46.87	$59.87	$122.07
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $210.35 / $210.35 / $210.35	Professional		$210.35	$210.35	$210.35
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $148.38 / $148.38 / $148.38	Professional	26	$148.38	$148.38	$148.38
United Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $70.20 / $179.49	Professional		$50.40	$70.20	$179.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.84 / $49.72 / $121.58	Professional	26	$35.84	$49.72	$121.58