Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.44 / $149.46 / $751.98	Facility	26	$136.44	$149.46	$751.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.61 / $142.61 / $142.61	Facility	26	$142.61	$142.61	$142.61
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $137.59 / $151.35 / $185.75	Professional	26	$137.59	$151.35	$185.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.85 / $171.54 / $288.72	Professional	26	$121.85	$171.54	$288.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $896.96 / $1,133.76 / $1,169.20	Facility	26	$896.96	$1,133.76	$1,169.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $142.61 / $142.61 / $142.61	Facility	26	$142.61	$142.61	$142.61