Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.79 / $20.89 / $119.87	Facility	26	$18.79	$20.89	$119.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.39 / $73.76 / $322.82	Professional		$59.39	$73.76	$322.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $20.89 / $106.52	Professional	26	$17.11	$20.89	$106.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $59.89 / $134.47	Professional		$36.28	$59.89	$134.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $24.27 / $49.87	Professional	26	$18.82	$24.27	$49.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $41.71 / $54.34 / $126.92	Professional		$41.71	$54.34	$126.92
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $16.89 / $42.26	Professional	26	$12.51	$16.89	$42.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.17 / $90.19 / $226.16	Professional		$39.17	$90.19	$226.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $25.57 / $56.34	Professional	26	$20.30	$25.57	$56.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.49 / $89.36 / $111.70	Professional		$24.49	$89.36	$111.70
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $21.89 / $28.29	Professional	26	$18.86	$21.89	$28.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $92.44 / $173.23	Professional		$69.13	$92.44	$173.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.61 / $27.36 / $47.72	Professional	26	$18.61	$27.36	$47.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $44.37 / $100.00 / $100.00	Facility	26	$44.37	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $490.88 / $490.88 / $569.17	Professional		$490.88	$490.88	$569.17
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.01 / $122.01 / $153.38	Professional	26	$122.01	$122.01	$153.38
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 $21.80 / $21.80 / $21.80	Facility	26	$21.80	$21.80	$21.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $95.46 / $202.28	Professional		$40.86	$95.46	$202.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $25.35 / $52.16	Professional	26	$20.02	$25.35	$52.16
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $258.45 / $258.45 / $258.45	Professional		$258.45	$258.45	$258.45
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $66.11 / $66.11 / $66.11	Professional	26	$66.11	$66.11	$66.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $72.28 / $99.39	Professional		$31.84	$72.28	$99.39
United Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $68.97 / $179.23	Professional		$45.02	$68.97	$179.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $20.35 / $46.21	Professional	26	$15.39	$20.35	$46.21