Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $70.79 / $371.54	Facility	26	$64.57	$70.79	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $416.87	Professional		$144.54	$173.78	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $295.12	Professional	26	$64.57	$102.33	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $269.15	Professional		$131.83	$138.04	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $380.19	Professional		$134.90	$186.21	$380.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $83.18 / $165.96	Professional	26	$56.23	$83.18	$165.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $380.19	Professional		$151.36	$204.17	$380.19
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.00 / $177.83	Professional	26	$74.13	$100.00	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $407.38	Professional		$154.88	$208.93	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $169.82	Professional	26	$69.18	$89.13	$169.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $281.84	Professional		$100.00	$151.36	$281.84
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $63.10 / $102.33	Professional	26	$41.69	$63.10	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $194.98 / $407.38	Professional		$158.49	$194.98	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $79.43 / $128.82	Professional	26	$64.57	$79.43	$128.82
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,288.25 / $1,288.25	Professional		$977.24	$1,288.25	$1,288.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $537.03 / $537.03	Professional	26	$426.58	$537.03	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $213.80	Professional		$95.50	$117.49	$213.80
Optum Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $39.81	Professional		$30.90	$30.90	$39.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $407.38	Professional		$154.88	$213.80	$407.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $87.10 / $158.49	Professional	26	$69.18	$87.10	$158.49
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	26	$229.09	$229.09	$229.09
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $269.15	Professional		$125.89	$199.53	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $331.13	Professional		$123.03	$165.96	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $144.54	Professional	26	$54.95	$72.44	$144.54