Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.46 / $34.08 / $195.57	Facility	26	$32.46	$34.08	$195.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $176.99 / $559.00	Professional		$118.48	$176.99	$559.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $40.03 / $169.00	Professional	26	$30.53	$40.03	$169.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.95 / $101.14 / $243.82	Professional	TC	$87.95	$101.14	$243.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $206.22 / $489.33	Professional		$165.00	$206.22	$489.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $33.27 / $72.11	Professional	26	$24.70	$33.27	$72.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.63 / $161.41 / $351.24	Professional		$122.63	$161.41	$351.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.45 / $45.15 / $93.78	Professional	26	$34.45	$45.15	$93.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.96 / $119.60 / $264.52	Professional	TC	$81.96	$119.60	$264.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $140.81 / $352.10	Professional		$100.00	$140.81	$352.10
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $27.51 / $35.44 / $97.05	Professional	26	$27.51	$35.44	$97.05
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $80.76 / $107.22 / $269.79	Professional	TC	$80.76	$107.22	$269.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.71 / $180.26 / $463.71	Professional		$97.71	$180.26	$463.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $43.41 / $92.54	Professional	26	$29.15	$43.41	$92.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.63 / $136.97 / $391.22	Professional	TC	$67.63	$136.97	$391.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.65 / $186.28 / $251.48	Professional		$67.65	$186.28	$251.48
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $36.04 / $48.67	Professional	26	$22.32	$36.04	$48.67
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.33 / $150.24 / $202.82	Professional	TC	$45.33	$150.24	$202.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.07 / $261.70 / $426.77	Professional		$199.07	$261.70	$426.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $44.89 / $75.53	Professional	26	$31.83	$44.89	$75.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $180.53 / $264.64 / $442.47	Professional	TC	$180.53	$264.64	$442.47
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $158.46 / $158.46	Facility	26	$100.00	$158.46	$158.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $898.89 / $898.89 / $1,186.05	Professional		$898.89	$898.89	$1,186.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $371.50 / $371.50 / $371.50	Professional	26	$371.50	$371.50	$371.50
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $695.99 / $695.99 / $929.03	Professional	TC	$695.99	$695.99	$929.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $186.55	Professional		$32.34	$32.34	$186.55
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.72 / $200.69 / $536.66	Professional		$104.72	$200.69	$536.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $42.40 / $90.74	Professional	26	$29.15	$42.40	$90.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $67.09 / $133.66 / $356.92	Professional	TC	$67.09	$133.66	$356.92
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $527.41 / $527.41 / $527.41	Professional		$527.41	$527.41	$527.41
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $109.63 / $109.63 / $109.63	Professional	26	$109.63	$109.63	$109.63
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $417.79 / $417.79 / $417.79	Professional	TC	$417.79	$417.79	$417.79
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $101.48 / $156.29 / $207.19	Professional		$101.48	$156.29	$207.19
United Facility/Professional Professional Modifier Low / Median / High Price $101.46 / $159.88 / $404.33	Professional		$101.46	$159.88	$404.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.30 / $34.29 / $95.21	Professional	26	$25.30	$34.29	$95.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.16 / $125.59 / $381.88	Professional	TC	$76.16	$125.59	$381.88