Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $81.28 / $229.09	Facility	26	$41.69	$81.28	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $218.78	Professional		$64.57	$85.11	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $204.17	Professional	26	$38.90	$48.98	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $251.19	Professional		$109.65	$151.36	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $95.50 / $158.49	Professional	26	$63.10	$95.50	$158.49
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $194.98	Professional		$66.07	$89.13	$194.98
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $52.48 / $120.23	Professional	26	$40.74	$52.48	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $223.87	Professional		$70.79	$95.50	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $131.83	Professional	26	$45.71	$58.88	$131.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $128.82	Professional		$58.88	$95.50	$128.82
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $47.86 / $64.57	Professional	26	$38.02	$47.86	$64.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $87.10 / $213.80	Professional		$72.44	$87.10	$213.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $43.65 / $75.86	Professional	26	$38.90	$43.65	$75.86
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $616.60	Professional		$489.78	$616.60	$616.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $331.13 / $331.13	Professional	26	$263.03	$331.13	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $104.71	Professional		$46.77	$57.54	$104.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $208.93	Professional		$72.44	$100.00	$208.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $57.54 / $114.82	Professional	26	$45.71	$57.54	$114.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $107.15	Professional		$58.88	$83.18	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $77.62 / $162.18	Professional		$54.95	$77.62	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.98 / $95.50	Professional	26	$34.67	$48.98	$95.50