Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.06 / $62.36 / $328.13	Facility	26	$56.06	$62.36	$328.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $321.13 / $941.09	Professional		$171.00	$321.13	$941.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $82.56 / $256.42	Professional	26	$54.50	$82.56	$256.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.48 / $261.63 / $588.91	Professional	TC	$110.48	$261.63	$588.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.33 / $271.91 / $338.64	Professional		$115.33	$271.91	$338.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $69.50 / $145.86	Professional	26	$39.45	$69.50	$145.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.48 / $369.73 / $606.25	Professional		$204.48	$369.73	$606.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.16 / $83.27 / $157.63	Professional	26	$57.16	$83.27	$157.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.56 / $288.35 / $456.38	Professional	TC	$135.56	$288.35	$456.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $138.96 / $212.65 / $518.77	Professional		$138.96	$212.65	$518.77
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $50.18 / $68.44 / $165.11	Professional	26	$50.18	$68.44	$165.11
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $145.29 / $347.70	Professional	TC	$100.00	$145.29	$347.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.85 / $285.81 / $561.27	Professional		$141.85	$285.81	$561.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $69.41 / $151.71	Professional	26	$33.97	$69.41	$151.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.63 / $216.60 / $411.71	Professional	TC	$95.63	$216.60	$411.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $146.65 / $198.21 / $267.58	Professional		$146.65	$198.21	$267.58
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.93 / $59.31 / $80.06	Professional	26	$46.93	$59.31	$80.06
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $138.90 / $187.52	Professional	TC	$99.72	$138.90	$187.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.91 / $200.37 / $372.63	Professional		$154.91	$200.37	$372.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $71.17 / $124.27	Professional	26	$52.46	$71.17	$124.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.13 / $160.69 / $260.57	Professional	TC	$107.13	$160.69	$260.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $488.64 / $488.64 / $498.88	Facility	26	$488.64	$488.64	$498.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,638.97 / $1,708.01 / $1,708.01	Professional		$1,638.97	$1,708.01	$1,708.01
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $384.71 / $384.71 / $428.03	Professional	26	$384.71	$384.71	$428.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,023.00 / $2,023.00 / $2,023.00	Professional	TC	$2,023.00	$2,023.00	$2,023.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $96.34	Professional		$32.34	$32.34	$96.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.55 / $310.20 / $488.07	Professional		$143.55	$310.20	$488.07
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $67.09 / $150.22	Professional	26	$33.54	$67.09	$150.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $95.63 / $220.14 / $395.35	Professional	TC	$95.63	$220.14	$395.35
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $556.00 / $556.00 / $556.00	Professional		$556.00	$556.00	$556.00
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $183.89 / $183.89 / $183.89	Professional	26	$183.89	$183.89	$183.89
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $372.11 / $372.11 / $372.11	Professional	TC	$372.11	$372.11	$372.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $160.30 / $220.41 / $561.23	Professional		$160.30	$220.41	$561.23
United Facility/Professional Professional Modifier Low / Median / High Price $144.18 / $233.13 / $465.21	Professional		$144.18	$233.13	$465.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.67 / $63.51 / $136.69	Professional	26	$47.67	$63.51	$136.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.10 / $169.40 / $365.36	Professional	TC	$95.10	$169.40	$365.36