Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.35 / $23.71 / $124.95	Facility	26	$21.35	$23.71	$124.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.44 / $38.64 / $83.57	Professional		$31.44	$38.64	$83.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.35 / $21.84 / $48.57	Professional	26	$18.35	$21.84	$48.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.46 / $51.13 / $110.03	Professional		$35.46	$51.13	$110.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.90 / $30.57 / $62.59	Professional	26	$22.90	$30.57	$62.59
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $25.66 / $36.43 / $91.67	Professional		$25.66	$36.43	$91.67
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $22.83 / $56.84	Professional	26	$15.98	$22.83	$56.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.51 / $23.51 / $23.51	Facility	26	$23.51	$23.51	$23.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.13 / $57.60 / $151.18	Professional		$36.13	$57.60	$151.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.44 / $30.30 / $71.70	Professional	26	$22.44	$30.30	$71.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $63.76 / $86.08	Professional		$36.61	$63.76	$86.08
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.87 / $25.04 / $30.73	Professional	26	$20.87	$25.04	$30.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.88 / $58.62 / $106.43	Professional		$46.88	$58.62	$106.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $22.76 / $49.62	Professional	26	$18.66	$22.76	$49.62
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.04 / $80.00 / $100.32	Facility	26	$48.04	$80.00	$100.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $331.15 / $331.15 / $420.15	Professional		$331.15	$331.15	$420.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.11 / $130.11 / $164.40	Professional	26	$130.11	$130.11	$164.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $32.34 / $70.56	Professional		$29.41	$32.34	$70.56
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.51 / $23.51 / $23.51	Facility	26	$23.51	$23.51	$23.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $62.72 / $135.62	Professional		$38.53	$62.72	$135.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.61 / $29.34 / $57.97	Professional	26	$22.61	$29.34	$57.97
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $148.84 / $148.84 / $148.84	Professional		$148.84	$148.84	$148.84
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $70.06 / $70.06	Professional	26	$70.06	$70.06	$70.06
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.61 / $54.93 / $70.90	Professional		$47.61	$54.93	$70.90
United Facility/Professional Professional Modifier Low / Median / High Price $30.72 / $44.45 / $105.32	Professional		$30.72	$44.45	$105.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.53 / $23.56 / $52.19	Professional	26	$16.53	$23.56	$52.19