Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.12 / $28.66 / $191.23	Facility	26	$27.12	$28.66	$191.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $53.81 / $217.46	Professional		$47.99	$53.81	$217.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $29.09 / $70.55	Professional	26	$26.07	$29.09	$70.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.64 / $85.92 / $233.34	Professional		$60.64	$85.92	$233.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.72 / $91.31	Professional	26	$33.11	$44.72	$91.31
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $48.83 / $60.00 / $146.63	Professional		$48.83	$60.00	$146.63
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.35 / $31.75 / $67.58	Professional	26	$23.35	$31.75	$67.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.02 / $158.02 / $158.02	Professional		$158.02	$158.02	$158.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $28.27 / $28.27	Professional	26	$28.27	$28.27	$28.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $45.23 / $236.57 / $319.37	Professional		$45.23	$236.57	$319.37
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.33 / $36.76 / $49.63	Professional	26	$25.33	$36.76	$49.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $179.76 / $236.57 / $414.22	Professional		$179.76	$236.57	$414.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.52 / $45.33 / $75.56	Professional	26	$31.52	$45.33	$75.56
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.51 / $159.16 / $159.16	Facility	26	$60.51	$159.16	$159.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,146.60 / $1,146.60 / $1,491.38	Professional		$1,146.60	$1,146.60	$1,491.38
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $196.77 / $196.77 / $256.88	Professional	26	$196.77	$196.77	$256.88
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 Professional Modifier Low / Median / High Price $116.42 / $158.02 / $304.10	Professional		$116.42	$158.02	$304.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $28.27 / $28.27	Professional	26	$28.27	$28.27	$28.27
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $393.33 / $393.33 / $393.33	Professional		$393.33	$393.33	$393.33
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $105.37 / $105.37 / $105.37	Professional	26	$105.37	$105.37	$105.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $81.41 / $263.13	Professional		$58.80	$81.41	$263.13
United Facility/Professional Professional Modifier Low / Median / High Price $55.70 / $149.33 / $359.66	Professional		$55.70	$149.33	$359.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $41.05 / $95.04	Professional	26	$22.74	$41.05	$95.04