Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.06 / $24.16 / $26.02	Facility	26	$23.06	$24.16	$26.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.95 / $137.59 / $224.10	Professional		$121.95	$137.59	$224.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.62 / $23.06 / $34.24	Professional	26	$22.62	$23.06	$34.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.35 / $137.35 / $137.35	Professional		$137.35	$137.35	$137.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.19 / $20.19 / $22.83	Professional	26	$20.19	$20.19	$22.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.32 / $214.78 / $428.85	Professional		$146.32	$214.78	$428.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.67 / $31.14 / $62.18	Professional	26	$24.67	$31.14	$62.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $117.66 / $189.93 / $453.87	Professional		$117.66	$189.93	$453.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $27.30 / $76.79	Professional	26	$22.74	$27.30	$76.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.52 / $216.52 / $472.78	Professional		$158.52	$216.52	$472.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $32.13 / $69.98	Professional	26	$24.48	$32.13	$69.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $142.97 / $174.03 / $234.94	Professional		$142.97	$174.03	$234.94
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $32.36 / $142.97	Professional	26	$23.97	$32.36	$142.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.13 / $190.56 / $342.69	Professional		$146.13	$190.56	$342.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $29.96 / $51.29	Professional	26	$21.57	$29.96	$51.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.98 / $102.96 / $108.44	Facility	26	$52.98	$102.96	$108.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $845.52 / $845.52 / $1,121.48	Professional		$845.52	$845.52	$1,121.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $147.91 / $187.20	Professional	26	$147.91	$147.91	$187.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $164.51	Professional		$32.34	$32.34	$164.51
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.72 / $26.72 / $26.72	Facility	26	$26.72	$26.72	$26.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $164.00 / $247.73 / $447.24	Professional		$164.00	$247.73	$447.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $31.47 / $64.20	Professional	26	$24.49	$31.47	$64.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $517.27 / $517.27 / $517.27	Professional		$517.27	$517.27	$517.27
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $78.40 / $78.40 / $78.40	Professional	26	$78.40	$78.40	$78.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $193.49 / $243.06	Professional		$140.72	$193.49	$243.06
United Facility/Professional Professional Modifier Low / Median / High Price $122.36 / $173.88 / $449.14	Professional		$122.36	$173.88	$449.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $27.67 / $68.59	Professional	26	$19.88	$27.67	$68.59