Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $51.29 / $295.12	Facility	26	$39.81	$51.29	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $234.42	Professional		$54.95	$72.44	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $54.95 / $275.42	Professional	26	$38.02	$54.95	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $58.88	Professional	TC	$16.98	$21.88	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	26	$91.20	$91.20	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $190.55	Professional		$67.61	$95.50	$190.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $64.57 / $128.82	Professional	26	$46.77	$64.57	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.84 / $58.88	Professional	TC	$20.42	$28.84	$58.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $218.78	Professional		$69.18	$97.72	$218.78
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $147.91	Professional	26	$47.86	$67.61	$147.91
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $69.18	Professional	TC	$20.89	$30.90	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $169.82	Professional		$56.23	$79.43	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $56.23 / $117.49	Professional	26	$38.90	$56.23	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $53.70	Professional	TC	$17.38	$25.70	$53.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $109.65	Professional		$53.70	$81.28	$109.65
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $72.44	Professional	26	$37.15	$53.70	$72.44
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $26.92 / $36.31	Professional	TC	$16.60	$26.92	$36.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $147.91	Professional		$64.57	$83.18	$147.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $63.10 / $109.65	Professional	26	$46.77	$63.10	$109.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $51.29	Professional	TC	$20.89	$30.90	$51.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	26	$288.40	$288.40	$288.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $537.03	Professional		$407.38	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	26	$407.38	$407.38	$407.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	TC	$407.38	$407.38	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $33.11 / $74.13	Professional		$17.38	$33.11	$74.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $165.96	Professional		$56.23	$81.28	$165.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $54.95 / $114.82	Professional	26	$39.81	$54.95	$114.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $53.70	Professional	TC	$17.38	$25.70	$53.70
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	26	$151.36	$151.36	$151.36
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	TC	$63.10	$63.10	$63.10
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $91.20 / $131.83	Professional		$66.07	$91.20	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $162.18	Professional		$47.86	$83.18	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $58.88 / $112.20	Professional	26	$33.88	$58.88	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.99 / $50.12	Professional	TC	$15.14	$23.99	$50.12