Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.41 / $763.98 / $2,078.33	Facility		$228.41	$763.98	$2,078.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.80 / $36.53 / $182.52	Facility	26	$30.80	$36.53	$182.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.46 / $198.00 / $787.71	Professional		$61.46	$198.00	$787.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.01 / $41.78 / $162.00	Professional	26	$29.01	$41.78	$162.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $170.38 / $240.37	Professional	TC	$27.64	$170.38	$240.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.48 / $57.97 / $306.92	Professional		$42.48	$57.97	$306.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.95 / $51.68 / $67.98	Professional	26	$22.95	$51.68	$67.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.41 / $293.92 / $876.00	Facility		$30.41	$293.92	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.02 / $203.25 / $293.45	Professional		$65.02	$203.25	$293.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.25 / $45.66 / $129.90	Professional	26	$29.25	$45.66	$129.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.40 / $158.08 / $239.29	Professional	TC	$33.40	$158.08	$239.29
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.50 / $100.00 / $1,010.49	Facility		$57.50	$100.00	$1,010.49
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $143.16 / $340.70	Professional		$100.00	$143.16	$340.70
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $28.03 / $35.19 / $97.56	Professional	26	$28.03	$35.19	$97.56
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $108.43 / $260.99	Professional	TC	$80.70	$108.43	$260.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $619.27 / $734.54	Facility		$68.95	$619.27	$734.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.08 / $127.06 / $292.47	Professional		$52.08	$127.06	$292.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.67 / $41.23 / $88.34	Professional	26	$27.67	$41.23	$88.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.17 / $68.09 / $211.98	Professional	TC	$25.17	$68.09	$211.98
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $72.81 / $98.29	Professional		$50.62	$72.81	$98.29
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.32 / $33.19 / $44.81	Professional	26	$26.32	$33.19	$44.81
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $39.61 / $53.49	Professional	TC	$24.30	$39.61	$53.49
HealthNet Facility/Professional Professional Modifier Low / Median / High Price $225.06 / $225.06 / $225.06	Professional		$225.06	$225.06	$225.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.47 / $77.29 / $164.00	Professional		$57.47	$77.29	$164.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $41.49 / $69.98	Professional	26	$29.59	$41.49	$69.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.70 / $46.51 / $77.76	Professional	TC	$31.70	$46.51	$77.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $126.61 / $889.98 / $889.98	Facility		$126.61	$889.98	$889.98
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $72.14 / $261.98 / $261.98	Facility	26	$72.14	$261.98	$261.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $947.00 / $947.00 / $953.33	Professional		$947.00	$947.00	$953.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $368.00 / $368.00 / $368.00	Professional	26	$368.00	$368.00	$368.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $758.00 / $758.00 / $758.00	Professional	TC	$758.00	$758.00	$758.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $36.11	Professional		$32.34	$32.34	$36.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $61.82 / $105.57 / $253.50	Facility		$61.82	$105.57	$253.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.91 / $128.72 / $253.46	Professional		$53.91	$128.72	$253.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.67 / $39.90 / $87.19	Professional	26	$27.67	$39.90	$87.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.17 / $77.12 / $212.51	Professional	TC	$25.17	$77.12	$212.51
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $189.16 / $189.16 / $189.16	Professional		$189.16	$189.16	$189.16
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $103.16 / $103.16 / $103.16	Professional	26	$103.16	$103.16	$103.16
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $85.99 / $85.99 / $85.99	Professional	TC	$85.99	$85.99	$85.99
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $80.95 / $163.19	Professional		$58.87	$80.95	$163.19
United Facility/Professional Professional Modifier Low / Median / High Price $58.47 / $84.25 / $208.78	Professional		$58.47	$84.25	$208.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.15 / $33.02 / $80.91	Professional	26	$24.15	$33.02	$80.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.99 / $40.33 / $149.59	Professional	TC	$25.99	$40.33	$149.59