Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.86 / $40.86 / $220.07	Facility	26	$36.86	$40.86	$220.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $69.47 / $273.00	Professional		$57.11	$69.47	$273.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $40.86 / $112.63	Professional	26	$32.96	$40.86	$112.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.94 / $71.94 / $71.94	Professional	26	$71.94	$71.94	$71.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.53 / $126.66 / $231.89	Professional		$62.53	$126.66	$231.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.27 / $77.30 / $136.36	Professional	26	$39.27	$77.30	$136.36
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $68.38 / $153.09	Professional		$47.87	$68.38	$153.09
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $40.17 / $66.14	Professional	26	$28.93	$40.17	$66.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.09 / $40.09 / $40.09	Facility	26	$40.09	$40.09	$40.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.28 / $87.46 / $228.53	Professional		$64.28	$87.46	$228.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.35 / $51.92 / $125.34	Professional	26	$39.35	$51.92	$125.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $54.13 / $86.60 / $116.91	Professional		$54.13	$86.60	$116.91
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $40.27 / $53.51	Professional	26	$33.56	$40.27	$53.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $80.17 / $188.79	Professional		$64.31	$80.17	$188.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $39.64 / $86.42	Professional	26	$32.36	$39.64	$86.42
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.11 / $85.00 / $173.80	Facility	26	$83.11	$85.00	$173.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $457.11 / $457.11 / $573.83	Professional		$457.11	$457.11	$573.83
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $229.85 / $229.85 / $281.25	Professional	26	$229.85	$229.85	$281.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.51 / $96.50	Professional		$32.34	$46.51	$96.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $40.09 / $40.09 / $40.09	Facility	26	$40.09	$40.09	$40.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.01 / $95.16 / $191.38	Professional		$65.01	$95.16	$191.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.71 / $50.45 / $104.12	Professional	26	$39.71	$50.45	$104.12
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $219.42 / $219.42 / $219.42	Professional		$219.42	$219.42	$219.42
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $122.60 / $122.60 / $122.60	Professional	26	$122.60	$122.60	$122.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.03 / $78.79 / $96.29	Professional		$70.03	$78.79	$96.29
United Facility/Professional Professional Modifier Low / Median / High Price $50.16 / $70.29 / $160.44	Professional		$50.16	$70.29	$160.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $42.56 / $103.21	Professional	26	$29.68	$42.56	$103.21