Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.25 / $46.93 / $254.63	Facility	26	$42.25	$46.93	$254.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.36 / $75.79 / $180.50	Professional		$62.36	$75.79	$180.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.27 / $46.47 / $129.16	Professional	26	$38.27	$46.47	$129.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $139.75 / $258.14	Professional		$76.00	$139.75	$258.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.26 / $87.26 / $156.55	Professional	26	$45.26	$87.26	$156.55
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $74.63 / $165.38	Professional		$52.24	$74.63	$165.38
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $47.59 / $100.00	Professional	26	$33.31	$47.59	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.61 / $46.61 / $46.61	Facility	26	$46.61	$46.61	$46.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.13 / $95.82 / $248.68	Professional		$70.13	$95.82	$248.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.56 / $59.59 / $143.86	Professional	26	$45.56	$59.59	$143.86
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $59.05 / $93.37 / $126.05	Professional		$59.05	$93.37	$126.05
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.38 / $46.06 / $62.03	Professional	26	$38.38	$46.06	$62.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.72 / $86.69 / $213.00	Professional		$69.72	$86.69	$213.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.52 / $45.95 / $100.17	Professional	26	$37.52	$45.95	$100.17
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $96.12 / $160.03 / $201.64	Facility	26	$96.12	$160.03	$201.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $493.66 / $493.66 / $623.25	Professional		$493.66	$493.66	$623.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $264.24 / $264.24 / $327.83	Professional	26	$264.24	$264.24	$327.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.96 / $105.15	Professional		$32.34	$46.96	$105.15
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $46.61 / $46.61 / $46.61	Facility	26	$46.61	$46.61	$46.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.94 / $103.54 / $206.65	Professional		$70.94	$103.54	$206.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $45.56 / $57.92 / $119.53	Professional	26	$45.56	$57.92	$119.53
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $238.75 / $238.75 / $238.75	Professional		$238.75	$238.75	$238.75
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $141.93 / $141.93 / $141.93	Professional	26	$141.93	$141.93	$141.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $75.50 / $84.94 / $103.82	Professional		$75.50	$84.94	$103.82
United Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $77.08 / $174.05	Professional		$55.08	$77.08	$174.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.44 / $47.76 / $105.64	Professional	26	$34.44	$47.76	$105.64