Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $32.36 / $67.61	Facility	26	$23.99	$32.36	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $81.28 / $229.09	Professional		$41.69	$81.28	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.88 / $112.20	Professional	26	$23.44	$33.88	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $53.70 / $120.23	Professional	TC	$15.14	$53.70	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.02 / $83.18	Professional		$36.31	$38.02	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $53.70 / $57.54	Professional	26	$45.71	$53.70	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $204.17	Professional		$79.43	$107.15	$204.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $38.90 / $77.62	Professional	26	$28.84	$38.90	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $67.61 / $120.23	Professional	TC	$42.66	$67.61	$120.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $234.42	Professional		$87.10	$117.49	$234.42
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $41.69 / $89.13	Professional	26	$29.51	$41.69	$89.13
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $74.13 / $144.54	Professional	TC	$51.29	$74.13	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $87.10 / $162.18	Professional		$40.74	$87.10	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $64.57	Professional	26	$23.44	$32.36	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $56.23 / $100.00	Professional	TC	$19.05	$56.23	$100.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $69.18	Professional		$34.67	$51.29	$69.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $28.18 / $38.02	Professional	26	$11.22	$28.18	$38.02
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $23.44 / $31.62	Professional	TC	$22.91	$23.44	$31.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $100.00	Professional		$40.74	$52.48	$100.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $57.54	Professional	26	$23.99	$33.11	$57.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $27.54 / $44.67	Professional	TC	$18.62	$27.54	$44.67
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Professional		$446.68	$446.68	$446.68
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	26	$338.84	$338.84	$338.84
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	TC	$338.84	$338.84	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $75.86	Professional		$28.18	$33.11	$75.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $87.10 / $154.88	Professional		$40.74	$87.10	$154.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $32.36 / $63.10	Professional	26	$22.91	$32.36	$63.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $56.23 / $97.72	Professional	TC	$19.05	$56.23	$97.72
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	TC	$79.43	$79.43	$79.43
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $131.83	Professional		$42.66	$57.54	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $134.90	Professional		$47.86	$61.66	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.90 / $58.88	Professional	26	$19.50	$30.90	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $77.62	Professional	TC	$23.99	$39.81	$77.62