Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.27 / $67.48 / $400.79	Facility	26	$60.27	$67.48	$400.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.13 / $123.41 / $473.00	Professional		$106.13	$123.41	$473.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.12 / $67.73 / $263.87	Professional	26	$59.12	$67.73	$263.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.80 / $126.51 / $190.07	Professional		$93.80	$126.51	$190.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.94 / $63.19 / $83.68	Professional	26	$55.94	$63.19	$83.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.08 / $159.15 / $330.65	Professional		$105.08	$159.15	$330.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.51 / $85.40 / $175.18	Professional	26	$58.51	$85.40	$175.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $83.09 / $110.76 / $264.37	Professional		$83.09	$110.76	$264.37
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $52.39 / $72.59 / $104.84	Professional	26	$52.39	$72.59	$104.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.07 / $155.69 / $353.93	Professional		$105.07	$155.69	$353.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.31 / $88.62 / $195.23	Professional	26	$69.31	$88.62	$195.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $102.19 / $136.51 / $184.29	Professional		$102.19	$136.51	$184.29
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.18 / $73.94 / $99.82	Professional	26	$55.18	$73.94	$99.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.75 / $132.54 / $256.64	Professional		$105.75	$132.54	$256.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.98 / $74.73 / $133.46	Professional	26	$60.98	$74.73	$133.46
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $149.97 / $292.17 / $321.77	Facility	26	$149.97	$292.17	$321.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $728.40 / $728.40 / $908.78	Professional		$728.40	$728.40	$908.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $414.32 / $414.32 / $520.04	Professional	26	$414.32	$414.32	$520.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $155.83	Professional		$32.34	$32.34	$155.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $174.29 / $309.12	Professional		$123.42	$174.29	$309.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.62 / $88.98 / $181.83	Professional	26	$69.62	$88.98	$181.83
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $403.93 / $403.93 / $403.93	Professional		$403.93	$403.93	$403.93
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $221.76 / $221.76 / $221.76	Professional	26	$221.76	$221.76	$221.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $110.39 / $132.84 / $173.72	Professional		$110.39	$132.84	$173.72
United Facility/Professional Professional Modifier Low / Median / High Price $96.32 / $130.72 / $344.03	Professional		$96.32	$130.72	$344.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.76 / $74.19 / $181.91	Professional	26	$53.76	$74.19	$181.91