Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $325.89 / $346.98 / $1,863.52	Facility	26	$325.89	$346.98	$1,863.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,118.21 / $1,251.91 / $3,106.48	Professional		$1,118.21	$1,251.91	$3,106.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $320.61 / $367.93 / $1,413.01	Professional	26	$320.61	$367.93	$1,413.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $292.80 / $292.80 / $292.80	Professional	26	$292.80	$292.80	$292.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,595.67 / $2,365.27 / $4,303.46	Professional		$1,595.67	$2,365.27	$4,303.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $457.49 / $653.94 / $1,167.40	Professional	26	$457.49	$653.94	$1,167.40
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $858.46 / $1,295.90 / $2,887.89	Professional		$858.46	$1,295.90	$2,887.89
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $229.77 / $340.57 / $758.86	Professional	26	$229.77	$340.57	$758.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,225.73 / $1,539.73 / $3,962.43	Professional		$1,225.73	$1,539.73	$3,962.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $348.49 / $436.18 / $1,153.54	Professional	26	$348.49	$436.18	$1,153.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,095.69 / $1,388.40 / $2,644.22	Professional		$1,095.69	$1,388.40	$2,644.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $307.30 / $427.99 / $785.31	Professional	26	$307.30	$427.99	$785.31
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2,401.92 / $2,924.64 / $3,007.60	Facility	26	$2,401.92	$2,924.64	$3,007.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,402.64 / $7,402.64 / $9,056.62	Professional		$7,402.64	$7,402.64	$9,056.62
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2,032.70 / $2,032.70 / $2,736.98	Professional	26	$2,032.70	$2,032.70	$2,736.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,217.76 / $1,539.73 / $3,654.43	Professional		$1,217.76	$1,539.73	$3,654.43
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $359.04 / $440.56 / $1,063.86	Professional	26	$359.04	$440.56	$1,063.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $3,879.50 / $3,879.50 / $3,879.50	Professional		$3,879.50	$3,879.50	$3,879.50
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $1,069.24 / $1,069.24 / $1,069.24	Professional	26	$1,069.24	$1,069.24	$1,069.24
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,048.57 / $1,467.99 / $1,994.83	Professional		$1,048.57	$1,467.99	$1,994.83
United Facility/Professional Professional Modifier Low / Median / High Price $959.91 / $1,357.10 / $3,150.96	Professional		$959.91	$1,357.10	$3,150.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $284.16 / $426.80 / $903.23	Professional	26	$284.16	$426.80	$903.23