Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.07 / $20.02 / $117.43	Facility	26	$18.07	$20.02	$117.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $77.23 / $290.00	Professional		$56.50	$77.23	$290.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $20.14 / $77.26	Professional	26	$17.98	$20.14	$77.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.59 / $36.59 / $36.59	Professional	26	$36.59	$36.59	$36.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $58.08 / $141.91	Professional		$37.07	$58.08	$141.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.59 / $24.22 / $48.06	Professional	26	$16.59	$24.22	$48.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $48.04 / $116.57	Professional		$36.99	$48.04	$116.57
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.05 / $17.69 / $43.86	Professional	26	$13.05	$17.69	$43.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.63 / $90.84 / $220.06	Professional		$39.63	$90.84	$220.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $24.97 / $56.34	Professional	26	$19.73	$24.97	$56.34
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.83 / $96.70 / $120.88	Professional		$24.83	$96.70	$120.88
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $21.89 / $28.68	Professional	26	$19.12	$21.89	$28.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.69 / $103.25 / $185.40	Professional		$74.69	$103.25	$185.40
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 $516.91 / $516.91 / $614.40	Professional		$516.91	$516.91	$614.40
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 $40.99 / $97.40 / $210.85	Professional		$40.99	$97.40	$210.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $24.82 / $52.16	Professional	26	$19.73	$24.82	$52.16
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $265.66 / $265.66 / $265.66	Professional		$265.66	$265.66	$265.66
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $64.90 / $64.90 / $64.90	Professional	26	$64.90	$64.90	$64.90
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $32.28 / $78.22 / $107.56	Professional		$32.28	$78.22	$107.56
United Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $69.13 / $184.29	Professional		$43.95	$69.13	$184.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $20.01 / $43.47	Professional	26	$15.12	$20.01	$43.47