Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $63.10 / $204.17	Facility	26	$32.36	$63.10	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $346.74	Professional		$70.79	$93.33	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $46.77 / $173.78	Professional	26	$28.84	$46.77	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $52.48 / $144.54	Professional	TC	$39.81	$52.48	$144.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $154.88	Professional		$107.15	$107.15	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $177.83	Professional	26	$42.66	$60.26	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $234.42	Professional		$87.10	$117.49	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $47.86 / $95.50	Professional	26	$34.67	$47.86	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $70.79 / $138.04	Professional	TC	$52.48	$70.79	$138.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $234.42	Professional		$89.13	$125.89	$234.42
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $51.29 / $97.72	Professional	26	$36.31	$51.29	$97.72
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $74.13 / $144.54	Professional	TC	$52.48	$74.13	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $38.02 / $53.70	Facility	26	$8.13	$38.02	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $194.98	Professional		$70.79	$107.15	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $43.65 / $83.18	Professional	26	$29.51	$43.65	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $63.10 / $125.89	Professional	TC	$41.69	$63.10	$125.89
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $138.04	Professional		$74.13	$102.33	$138.04
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $37.15 / $50.12	Professional	26	$30.90	$37.15	$50.12
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $66.07 / $89.13	Professional	TC	$43.65	$66.07	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $181.97	Professional		$75.86	$97.72	$181.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $69.18	Professional	26	$32.36	$42.66	$69.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $70.79 / $125.89	Professional	TC	$54.95	$70.79	$125.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	26	$208.93	$208.93	$208.93
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $676.08 / $676.08	Professional		$549.54	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.93 / $269.15 / $269.15	Professional	26	$208.93	$269.15	$269.15
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $407.38 / $407.38	Professional	TC	$338.84	$407.38	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $38.02 / $53.70	Facility	26	$8.13	$38.02	$53.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $213.80	Professional		$70.79	$109.65	$213.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $41.69 / $77.62	Professional	26	$29.51	$41.69	$77.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $61.66 / $114.82	Professional	TC	$40.74	$61.66	$114.82
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	26	$114.82	$114.82	$114.82
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	TC	$158.49	$158.49	$158.49
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $125.89	Professional		$74.13	$97.72	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $177.83	Professional		$66.07	$83.18	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $72.44	Professional	26	$27.54	$35.48	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $47.86 / $104.71	Professional	TC	$38.02	$47.86	$104.71