Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.44 / $65.63 / $518.07	Facility	26	$59.44	$65.63	$518.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.40 / $100.40 / $100.40	Facility	26	$100.40	$100.40	$100.40
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.41 / $104.95 / $128.80	Professional	26	$95.41	$104.95	$128.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.14 / $119.20 / $201.43	Professional	26	$85.14	$119.20	$201.43
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $204.35 / $396.63 / $425.03	Facility	26	$204.35	$396.63	$425.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $100.40 / $100.40 / $100.40	Facility	26	$100.40	$100.40	$100.40