Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $77.62 / $131.83	Facility		$25.70	$77.62	$131.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $22.39 / $354.81	Facility	26	$15.14	$22.39	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $42.66 / $338.84	Professional		$12.59	$42.66	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $45.71 / $144.54	Professional	26	$15.49	$45.71	$144.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $109.65	Professional	26	$77.62	$77.62	$109.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $8.71 / $15.85	Facility		$7.59	$8.71	$15.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $120.23 / $223.87	Professional		$18.62	$120.23	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.91 / $61.66	Professional	26	$16.60	$22.91	$61.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.84 / $100.00	Professional		$19.95	$28.84	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.88 / $60.26	Professional	26	$16.98	$21.88	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.29 / $6.03 / $15.49	Facility		$2.29	$6.03	$15.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $56.23 / $75.86	Professional		$15.85	$56.23	$75.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $51.29 / $69.18	Professional	26	$15.85	$51.29	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $89.13	Professional		$44.67	$56.23	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $58.88 / $91.20	Professional	26	$41.69	$58.88	$91.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $389.05 / $389.05	Professional		$302.00	$389.05	$389.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $363.08 / $363.08	Professional	26	$281.84	$363.08	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $70.79	Professional		$70.79	$70.79	$70.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $3.72 / $27.54 / $72.44	Facility		$3.72	$27.54	$72.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $93.33	Professional		$43.65	$43.65	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	26	$60.26	$60.26	$60.26
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $26.92 / $51.29	Professional		$15.85	$26.92	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $23.44 / $67.61	Professional		$15.85	$23.44	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $23.44 / $66.07	Professional	26	$15.85	$23.44	$66.07