Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.82 / $21.79 / $129.38	Facility	26	$20.82	$21.79	$129.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $70.01 / $203.94	Professional		$55.14	$70.01	$203.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.28 / $21.62 / $93.46	Professional	26	$18.28	$21.62	$93.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.69 / $48.34 / $140.05	Professional	TC	$36.69	$48.34	$140.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.28 / $34.28 / $34.28	Professional	26	$34.28	$34.28	$34.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $83.72 / $168.14	Professional		$62.32	$83.72	$168.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $29.20 / $56.59	Professional	26	$23.23	$29.20	$56.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.85 / $55.24 / $108.33	Professional	TC	$37.85	$55.24	$108.33
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $61.47 / $79.31 / $180.68	Professional		$61.47	$79.31	$180.68
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.93 / $26.51 / $61.03	Professional	26	$20.93	$26.51	$61.03
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $42.13 / $53.72 / $126.93	Professional	TC	$42.13	$53.72	$126.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.76 / $83.36 / $183.52	Professional		$57.76	$83.36	$183.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $26.79 / $60.36	Professional	26	$18.86	$26.79	$60.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $57.78 / $127.26	Professional	TC	$38.11	$57.78	$127.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $84.31 / $113.82	Professional		$56.42	$84.31	$113.82
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $23.12 / $31.21	Professional	26	$19.18	$23.12	$31.21
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.24 / $61.19 / $82.61	Professional	TC	$37.24	$61.19	$82.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.87 / $84.01 / $141.94	Professional		$63.87	$84.01	$141.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $27.74 / $43.47	Professional	26	$20.45	$27.74	$43.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.95 / $70.80 / $114.79	Professional	TC	$48.95	$70.80	$114.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.44 / $101.94 / $101.94	Facility	26	$78.44	$101.94	$101.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $420.07 / $420.07 / $547.20	Professional		$420.07	$420.07	$547.20
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $132.09 / $166.95	Professional	26	$132.09	$132.09	$166.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.04 / $288.04 / $380.25	Professional	TC	$288.04	$288.04	$380.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $40.74	Professional		$32.34	$32.34	$40.74
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.41 / $92.05 / $179.78	Professional		$58.41	$92.05	$179.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $26.29 / $59.24	Professional	26	$18.86	$26.29	$59.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $57.22 / $122.02	Professional	TC	$38.11	$57.22	$122.02
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $210.10 / $210.10 / $210.10	Professional		$210.10	$210.10	$210.10
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $72.41 / $72.41 / $72.41	Professional	26	$72.41	$72.41	$72.41
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $137.69 / $137.69 / $137.69	Professional	TC	$137.69	$137.69	$137.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $68.18 / $78.98 / $95.92	Professional		$68.18	$78.98	$95.92
United Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $70.80 / $211.95	Professional		$50.58	$70.80	$211.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $23.28 / $56.03	Professional	26	$17.05	$23.28	$56.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.10 / $48.67 / $116.49	Professional	TC	$34.10	$48.67	$116.49