Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.44 / $94.60 / $530.47	Facility	26	$87.44	$94.60	$530.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.24 / $99.24 / $99.24	Facility	26	$99.24	$99.24	$99.24
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.40 / $104.94 / $128.79	Professional	26	$95.40	$104.94	$128.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.80 / $118.72 / $200.88	Professional	26	$84.80	$118.72	$200.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $203.34 / $392.09 / $422.89	Facility	26	$203.34	$392.09	$422.89
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $99.24 / $99.24 / $99.24	Facility	26	$99.24	$99.24	$99.24