Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $237.17 / $252.35 / $1,333.94	Facility	26	$237.17	$252.35	$1,333.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $839.60 / $961.32 / $2,661.90	Professional		$839.60	$961.32	$2,661.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $232.79 / $261.11 / $1,042.00	Professional	26	$232.79	$261.11	$1,042.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $186.23 / $194.66 / $209.51	Professional	26	$186.23	$194.66	$209.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,198.09 / $1,775.94 / $3,292.58	Professional		$1,198.09	$1,775.94	$3,292.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $332.81 / $475.71 / $849.23	Professional	26	$332.81	$475.71	$849.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $649.79 / $981.22 / $2,228.28	Professional		$649.79	$981.22	$2,228.28
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $167.06 / $247.67 / $551.86	Professional	26	$167.06	$247.67	$551.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $955.20 / $1,200.78 / $3,310.87	Professional		$955.20	$1,200.78	$3,310.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $251.32 / $315.10 / $839.34	Professional	26	$251.32	$315.10	$839.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $787.65 / $998.97 / $1,442.62	Professional		$787.65	$998.97	$1,442.62
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $212.67 / $244.39 / $319.01	Professional	26	$212.67	$244.39	$319.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $886.79 / $1,125.63 / $2,031.06	Professional		$886.79	$1,125.63	$2,031.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $219.95 / $306.33 / $562.10	Professional	26	$219.95	$306.33	$562.10
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,718.00 / $2,092.32 / $2,151.76	Facility	26	$1,718.00	$2,092.32	$2,151.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,012.88 / $6,012.88 / $7,302.75	Professional		$6,012.88	$6,012.88	$7,302.75
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,456.11 / $1,456.11 / $1,957.43	Professional	26	$1,456.11	$1,456.11	$1,957.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $953.00 / $1,206.56 / $2,844.17	Professional		$953.00	$1,206.56	$2,844.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $257.85 / $317.89 / $774.10	Professional	26	$257.85	$317.89	$774.10
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,050.88 / $3,050.88 / $3,050.88	Professional		$3,050.88	$3,050.88	$3,050.88
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $764.76 / $764.76 / $764.76	Professional	26	$764.76	$764.76	$764.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $787.65 / $1,102.71 / $1,498.46	Professional		$787.65	$1,102.71	$1,498.46
United Facility/Professional Professional Modifier Low / Median / High Price $753.14 / $1,062.58 / $2,761.70	Professional		$753.14	$1,062.58	$2,761.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $200.97 / $304.92 / $672.08	Professional	26	$200.97	$304.92	$672.08