Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.39 / $38.45 / $224.80	Facility	26	$34.39	$38.45	$224.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.61 / $87.00 / $204.78	Professional		$72.61	$87.00	$204.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.77 / $38.42 / $95.60	Professional	26	$33.77	$38.42	$95.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.66 / $77.41 / $102.60	Professional		$67.66	$77.41	$102.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.67 / $63.67 / $63.67	Professional	26	$63.67	$63.67	$63.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.88 / $95.88 / $200.72	Professional		$71.88	$95.88	$200.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.90 / $42.68 / $89.75	Professional	26	$33.90	$42.68	$89.75
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $52.76 / $70.95 / $167.38	Professional		$52.76	$70.95	$167.38
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $22.68 / $63.41	Professional	26	$16.48	$22.68	$63.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.59 / $111.88 / $251.61	Professional		$83.59	$111.88	$251.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $50.25 / $109.95	Professional	26	$38.90	$50.25	$109.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $68.83 / $87.30 / $139.66	Professional		$68.83	$87.30	$139.66
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.66 / $40.15 / $56.00	Professional	26	$31.66	$40.15	$56.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.06 / $100.92 / $187.00	Professional		$79.06	$100.92	$187.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.27 / $41.92 / $74.87	Professional	26	$34.27	$41.92	$74.87
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $84.60 / $165.02 / $181.07	Facility	26	$84.60	$165.02	$181.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $553.27 / $553.27 / $676.35	Professional		$553.27	$553.27	$676.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $234.24 / $234.24 / $294.52	Professional	26	$234.24	$234.24	$294.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $114.20	Professional		$32.34	$32.34	$114.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.49 / $124.72 / $230.91	Professional		$86.49	$124.72	$230.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.53 / $50.38 / $102.60	Professional	26	$39.53	$50.38	$102.60
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $283.27 / $283.27 / $283.27	Professional		$283.27	$283.27	$283.27
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $124.60 / $124.60 / $124.60	Professional	26	$124.60	$124.60	$124.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.58 / $94.12 / $130.94	Professional		$71.58	$94.12	$130.94
United Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $93.20 / $240.74	Professional		$67.20	$93.20	$240.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.24 / $42.04 / $97.10	Professional	26	$30.24	$42.04	$97.10