Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.14 / $26.28 / $159.51	Facility	26	$25.14	$26.28	$159.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $121.55 / $316.47	Professional		$97.57	$121.55	$316.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $26.22 / $75.94	Professional	26	$22.70	$26.22	$75.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $94.35 / $232.71	Professional	TC	$73.93	$94.35	$232.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.52 / $43.52 / $59.89	Professional	26	$43.52	$43.52	$59.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.18 / $139.22 / $294.58	Professional		$99.18	$139.22	$294.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.34 / $38.27 / $116.13	Professional	26	$26.34	$38.27	$116.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.31 / $102.61 / $206.48	Professional	TC	$71.31	$102.61	$206.48
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $117.08 / $288.75	Professional		$90.89	$117.08	$288.75
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $28.75 / $71.69	Professional	26	$22.80	$28.75	$71.69
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $67.09 / $89.45 / $217.10	Professional	TC	$67.09	$89.45	$217.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.23 / $145.94 / $317.36	Professional		$98.23	$145.94	$317.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.30 / $33.53 / $73.08	Professional	26	$23.30	$33.53	$73.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.01 / $112.81 / $277.58	Professional	TC	$77.01	$112.81	$277.58
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $50.69 / $171.05 / $230.92	Professional		$50.69	$171.05	$230.92
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $29.99 / $40.49	Professional	26	$13.18	$29.99	$40.49
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.51 / $141.06 / $190.43	Professional	TC	$37.51	$141.06	$190.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.57 / $168.53 / $279.91	Professional		$124.57	$168.53	$279.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.39 / $35.99 / $56.96	Professional	26	$26.39	$35.99	$56.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $112.85 / $163.08 / $264.45	Professional	TC	$112.85	$163.08	$264.45
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $131.81 / $131.81	Facility	26	$100.00	$131.81	$131.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $859.12 / $859.12 / $1,089.08	Professional		$859.12	$859.12	$1,089.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $211.35 / $211.35 / $216.60	Professional	26	$211.35	$211.35	$216.60
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $689.44 / $689.44 / $872.40	Professional	TC	$689.44	$689.44	$872.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $96.68	Professional		$32.34	$32.34	$96.68
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.72 / $165.73 / $357.60	Professional		$104.72	$165.73	$357.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.66 / $32.92 / $73.03	Professional	26	$23.66	$32.92	$73.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $78.83 / $109.43 / $245.05	Professional	TC	$78.83	$109.43	$245.05
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $402.59 / $402.59 / $402.59	Professional		$402.59	$402.59	$402.59
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $89.39 / $89.39 / $89.39	Professional	26	$89.39	$89.39	$89.39
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $313.20 / $313.20 / $313.20	Professional	TC	$313.20	$313.20	$313.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $138.34 / $190.22	Professional		$76.04	$138.34	$190.22
United Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $122.34 / $408.40	Professional		$82.13	$122.34	$408.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $28.84 / $67.42	Professional	26	$21.30	$28.84	$67.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.52 / $95.74 / $273.38	Professional	TC	$62.52	$95.74	$273.38