Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.23 / $11.79 / $71.81	Facility	26	$11.23	$11.79	$71.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $96.07 / $385.20	Professional		$75.05	$96.07	$385.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $12.35 / $60.00	Professional	26	$10.61	$12.35	$60.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $84.10 / $334.14	Professional	TC	$64.44	$84.10	$334.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.31 / $114.31 / $114.31	Professional		$114.31	$114.31	$114.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $9.52 / $9.52	Professional	26	$9.52	$9.52	$9.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.08 / $129.26 / $286.58	Professional		$74.08	$129.26	$286.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $17.17 / $33.24	Professional	26	$13.09	$17.17	$33.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.93 / $109.38 / $256.11	Professional	TC	$60.93	$109.38	$256.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $70.47 / $91.78 / $220.43	Professional		$70.47	$91.78	$220.43
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.46 / $14.19 / $32.29	Professional	26	$10.46	$14.19	$32.29
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $60.01 / $77.59 / $190.67	Professional	TC	$60.01	$77.59	$190.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $163.44 / $337.41	Professional		$84.71	$163.44	$337.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $13.59 / $32.86	Professional	26	$7.02	$13.59	$32.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.47 / $140.76 / $308.80	Professional	TC	$78.47	$140.76	$308.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $147.83 / $181.43	Professional		$134.38	$147.83	$181.43
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $14.38 / $17.64	Professional	26	$13.07	$14.38	$17.64
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $121.32 / $133.44 / $163.78	Professional	TC	$121.32	$133.44	$163.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.88 / $134.38 / $234.14	Professional		$102.88	$134.38	$234.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $15.68 / $24.57	Professional	26	$11.56	$15.68	$24.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.52 / $139.52 / $227.47	Professional	TC	$93.52	$139.52	$227.47
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $107.60 / $107.60 / $110.80	Facility	26	$107.60	$107.60	$110.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $876.62 / $902.92 / $902.92	Professional		$876.62	$902.92	$902.92
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $270.04 / $270.04 / $270.04	Professional	26	$270.04	$270.04	$270.04
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $820.61 / $845.22 / $845.22	Professional	TC	$820.61	$845.22	$845.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $85.67	Professional		$32.34	$32.34	$85.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.26 / $191.40 / $320.20	Professional		$88.26	$191.40	$320.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $12.92 / $32.36	Professional	26	$6.46	$12.92	$32.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $76.37 / $140.00 / $305.30	Professional	TC	$76.37	$140.00	$305.30
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $384.72 / $384.72 / $384.72	Professional		$384.72	$384.72	$384.72
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.26 / $40.26 / $40.26	Professional	26	$40.26	$40.26	$40.26
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $344.46 / $344.46 / $344.46	Professional	TC	$344.46	$344.46	$344.46
United Facility/Professional Professional Modifier Low / Median / High Price $98.78 / $127.02 / $296.13	Professional		$98.78	$127.02	$296.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $12.63 / $35.02	Professional	26	$8.94	$12.63	$35.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.04 / $113.94 / $269.08	Professional	TC	$88.04	$113.94	$269.08