Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.74 / $32.79 / $194.12	Facility	26	$28.74	$32.79	$194.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.41 / $151.88 / $864.04	Professional		$62.41	$151.88	$864.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.73 / $186.93 / $842.29	Professional	26	$28.73	$186.93	$842.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $44.02 / $180.00	Professional	TC	$35.34	$44.02	$180.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.66 / $77.44 / $162.69	Professional		$55.66	$77.44	$162.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.23 / $63.26 / $81.59	Professional	26	$31.23	$63.26	$81.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $99.15 / $194.84	Professional		$73.95	$99.15	$194.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.27 / $41.99 / $83.83	Professional	26	$33.27	$41.99	$83.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.88 / $56.63 / $109.41	Professional	TC	$39.88	$56.63	$109.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $93.97 / $216.88	Professional		$73.72	$93.97	$216.88
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.82 / $39.72 / $100.00	Professional	26	$32.82	$39.72	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $40.90 / $54.58 / $121.31	Professional	TC	$40.90	$54.58	$121.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.83 / $90.71 / $195.10	Professional		$56.83	$90.71	$195.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.72 / $39.22 / $89.65	Professional	26	$27.72	$39.22	$89.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.86 / $52.29 / $106.22	Professional	TC	$30.86	$52.29	$106.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $84.82 / $114.51	Professional		$56.12	$84.82	$114.51
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $37.86 / $51.11	Professional	26	$26.38	$37.86	$51.11
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.74 / $46.96 / $63.40	Professional	TC	$29.74	$46.96	$63.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.11 / $85.73 / $159.46	Professional		$66.11	$85.73	$159.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.52 / $46.83 / $78.18	Professional	26	$32.52	$46.83	$78.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.24 / $55.12 / $88.28	Professional	TC	$36.24	$55.12	$88.28
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $170.00 / $170.00	Facility	26	$85.90	$170.00	$170.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $468.00 / $468.11 / $560.92	Professional		$468.00	$468.11	$560.92
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $378.10 / $378.10 / $378.10	Professional	26	$378.10	$378.10	$378.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $378.10 / $378.10 / $378.10	Professional	TC	$378.10	$378.10	$378.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $94.56 / $191.85	Professional		$60.12	$94.56	$191.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $39.22 / $87.77	Professional	26	$28.07	$39.22	$87.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.60 / $54.75 / $103.18	Professional	TC	$31.60	$54.75	$103.18
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $221.22 / $221.22 / $221.22	Professional		$221.22	$221.22	$221.22
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $107.57 / $107.57 / $107.57	Professional	26	$107.57	$107.57	$107.57
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $113.64 / $113.64 / $113.64	Professional	TC	$113.64	$113.64	$113.64
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $68.58 / $94.30 / $307.39	Professional		$68.58	$94.30	$307.39
United Facility/Professional Professional Modifier Low / Median / High Price $57.12 / $84.81 / $197.81	Professional		$57.12	$84.81	$197.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.06 / $41.95 / $96.90	Professional	26	$24.06	$41.95	$96.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $43.28 / $100.73	Professional	TC	$34.29	$43.28	$100.73