Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.05 / $53.25 / $129.12	Facility		$18.05	$53.25	$129.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.67 / $18.44 / $139.85	Facility	26	$15.67	$18.44	$139.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.63 / $18.44 / $77.50	Professional		$12.63	$18.44	$77.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.57 / $39.38 / $96.79	Professional	26	$15.57	$39.38	$96.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.59 / $75.51 / $115.98	Professional	26	$44.59	$75.51	$115.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7.68 / $169.00 / $876.00	Facility		$7.68	$169.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.64 / $204.68 / $256.18	Professional		$95.64	$204.68	$256.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.49 / $22.28 / $52.12	Professional	26	$7.49	$22.28	$52.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $36.21 / $74.50	Professional		$20.05	$36.21	$74.50
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.98 / $29.39	Professional	26	$13.80	$18.98	$29.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.24 / $6.08 / $14.78	Facility		$2.24	$6.08	$14.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $43.45	Professional		$43.45	$43.45	$43.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	26	$40.47	$40.47	$40.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $15.89 / $56.43 / $76.18	Professional		$15.89	$56.43	$76.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.89 / $52.15 / $70.40	Professional	26	$15.89	$52.15	$70.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.34 / $58.86 / $113.28	Professional		$46.34	$58.86	$113.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.29 / $62.58 / $108.08	Professional	26	$42.29	$62.58	$108.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $242.00 / $244.58	Facility		$85.00	$242.00	$244.58
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.00 / $223.26 / $227.00	Facility	26	$85.00	$223.26	$227.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.45 / $302.45 / $392.55	Professional		$302.45	$302.45	$392.55
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $283.52 / $283.52 / $363.08	Professional	26	$283.52	$283.52	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $3.13 / $16.45 / $66.94	Facility		$3.13	$16.45	$66.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.45 / $43.45 / $141.63	Professional		$43.45	$43.45	$141.63
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $40.47 / $94.87	Professional	26	$40.47	$40.47	$94.87
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $60.74 / $60.74 / $60.74	Professional	26	$60.74	$60.74	$60.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $20.66 / $28.60 / $62.73	Professional		$20.66	$28.60	$62.73
United Facility/Professional Professional Modifier Low / Median / High Price $15.91 / $23.98 / $67.50	Professional		$15.91	$23.98	$67.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $23.33 / $73.40	Professional	26	$15.37	$23.33	$73.40