Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.51 / $70.87 / $404.28	Facility	26	$64.51	$70.87	$404.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.02 / $167.34 / $308.55	Professional		$144.02	$167.34	$308.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.01 / $72.52 / $286.22	Professional	26	$64.01	$72.52	$286.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.04 / $182.04 / $312.51	Professional		$182.04	$182.04	$312.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $135.24 / $328.60	Professional	26	$58.62	$135.24	$328.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.85 / $184.66 / $370.51	Professional		$143.85	$184.66	$370.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.00 / $83.55 / $166.04	Professional	26	$62.00	$83.55	$166.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $117.14 / $172.16 / $353.91	Professional		$117.14	$172.16	$353.91
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $59.07 / $84.38 / $159.83	Professional	26	$59.07	$84.38	$159.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.80 / $76.80 / $76.80	Facility	26	$76.80	$76.80	$76.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.21 / $210.49 / $456.09	Professional		$153.21	$210.49	$456.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.00 / $89.14 / $183.08	Professional	26	$70.00	$89.14	$183.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $99.61 / $195.22 / $253.79	Professional		$99.61	$195.22	$253.79
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.84 / $74.08 / $100.01	Professional	26	$41.84	$74.08	$100.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.37 / $179.76 / $383.00	Professional		$144.37	$179.76	$383.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.88 / $85.19 / $155.57	Professional	26	$60.88	$85.19	$155.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $157.36 / $302.75 / $327.56	Facility	26	$157.36	$302.75	$327.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $982.06 / $982.06 / $1,296.45	Professional		$982.06	$982.06	$1,296.45
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $428.85 / $428.85 / $540.45	Professional	26	$428.85	$428.85	$540.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $214.78	Professional		$32.34	$32.34	$214.78
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $76.80 / $76.80 / $76.80	Facility	26	$76.80	$76.80	$76.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.41 / $227.83 / $411.51	Professional		$160.41	$227.83	$411.51
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $70.00 / $87.50 / $171.64	Professional	26	$70.00	$87.50	$171.64
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $527.73 / $527.73 / $527.73	Professional		$527.73	$527.73	$527.73
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $227.65 / $227.65 / $227.65	Professional	26	$227.65	$227.65	$227.65
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $189.51 / $271.83	Professional		$142.88	$189.51	$271.83
United Facility/Professional Professional Modifier Low / Median / High Price $123.62 / $166.50 / $371.01	Professional		$123.62	$166.50	$371.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.73 / $71.81 / $152.09	Professional	26	$53.73	$71.81	$152.09