Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.11 / $23.96 / $25.02	Facility	26	$22.11	$23.96	$25.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $74.34 / $109.19	Professional		$64.94	$74.34	$109.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $23.05 / $32.64	Professional	26	$20.45	$23.05	$32.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.01 / $26.01 / $26.01	Professional	26	$26.01	$26.01	$26.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $83.72 / $165.18	Professional		$66.84	$83.72	$165.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $25.47 / $49.94	Professional	26	$20.21	$25.47	$49.94
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $57.18 / $81.28 / $153.87	Professional		$57.18	$81.28	$153.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $23.58 / $53.44	Professional	26	$16.26	$23.58	$53.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.49 / $24.49 / $24.49	Facility	26	$24.49	$24.49	$24.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.84 / $100.07 / $196.47	Professional		$76.84	$100.07	$196.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.82 / $30.67 / $59.21	Professional	26	$23.82	$30.67	$59.21
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $66.53 / $83.77 / $113.09	Professional		$66.53	$83.77	$113.09
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.36 / $30.37 / $66.53	Professional	26	$23.36	$30.37	$66.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.47 / $76.44 / $184.42	Professional		$61.47	$76.44	$184.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.29 / $26.86 / $42.16	Professional	26	$19.29	$26.86	$42.16
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $51.03 / $95.38 / $103.36	Facility	26	$51.03	$95.38	$103.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $437.32 / $437.32 / $546.00	Professional		$437.32	$437.32	$546.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.18 / $141.18 / $167.40	Professional	26	$141.18	$141.18	$167.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $24.49 / $24.49 / $24.49	Facility	26	$24.49	$24.49	$24.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $108.30 / $188.71	Professional		$77.84	$108.30	$188.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.29 / $30.19 / $55.77	Professional	26	$24.29	$30.19	$55.77
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $66.53 / $76.20 / $113.11	Professional		$66.53	$76.20	$113.11
United Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $79.90 / $176.31	Professional		$58.46	$79.90	$176.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.09 / $24.79 / $52.18	Professional	26	$18.09	$24.79	$52.18