Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $243.15 / $269.32 / $1,438.12	Facility	26	$243.15	$269.32	$1,438.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $280.45 / $280.45 / $280.45	Facility	26	$280.45	$280.45	$280.45
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $259.92 / $330.66 / $503.24	Professional	26	$259.92	$330.66	$503.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $215.48 / $259.92 / $566.63	Professional	26	$215.48	$259.92	$566.63
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $1,811.20 / $2,206.88 / $2,263.28	Facility	26	$1,811.20	$2,206.88	$2,263.28
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $280.45 / $280.45 / $280.45	Facility	26	$280.45	$280.45	$280.45