Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $32.99 / $210.95	Facility	26	$31.27	$32.99	$210.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.39 / $323.39 / $958.73	Professional		$286.39	$323.39	$958.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.39 / $40.49 / $162.43	Professional	26	$30.39	$40.49	$162.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.41 / $292.58 / $798.86	Professional	TC	$257.41	$292.58	$798.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $384.51 / $384.51 / $384.51	Professional		$384.51	$384.51	$384.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.49 / $46.10 / $70.47	Professional	26	$35.49	$46.10	$70.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.75 / $473.11 / $982.42	Professional		$331.75	$473.11	$982.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.03 / $44.98 / $92.42	Professional	26	$33.03	$44.98	$92.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $293.13 / $428.61 / $890.00	Professional	TC	$293.13	$428.61	$890.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $247.05 / $388.22 / $940.65	Professional		$247.05	$388.22	$940.65
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $37.95 / $100.00	Professional	26	$32.14	$37.95	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $222.05 / $348.94 / $848.34	Professional	TC	$222.05	$348.94	$848.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.36 / $421.31 / $988.07	Professional		$286.36	$421.31	$988.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $45.33 / $100.56	Professional	26	$31.34	$45.33	$100.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $267.25 / $397.24 / $936.62	Professional	TC	$267.25	$397.24	$936.62
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $291.01 / $388.88 / $524.99	Professional		$291.01	$388.88	$524.99
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $38.09 / $51.42	Professional	26	$29.10	$38.09	$51.42
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $261.91 / $350.79 / $473.57	Professional	TC	$261.91	$350.79	$473.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.77 / $380.73 / $680.12	Professional		$288.77	$380.73	$680.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $45.67 / $80.09	Professional	26	$31.36	$45.67	$80.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $269.20 / $388.79 / $659.49	Professional	TC	$269.20	$388.79	$659.49
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $81.73 / $155.94 / $168.58	Facility	26	$81.73	$155.94	$168.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,991.14 / $1,991.14 / $2,452.35	Professional		$1,991.14	$1,991.14	$2,452.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $218.97 / $218.97 / $277.95	Professional	26	$218.97	$218.97	$277.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,772.11 / $1,772.11 / $2,174.40	Professional	TC	$1,772.11	$1,772.11	$2,174.40
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 $286.36 / $420.75 / $985.26	Professional		$286.36	$420.75	$985.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $45.34 / $99.09	Professional	26	$31.83	$45.34	$99.09
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $284.72 / $400.83 / $936.62	Professional	TC	$284.72	$400.83	$936.62
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,119.46 / $1,119.46 / $1,119.46	Professional		$1,119.46	$1,119.46	$1,119.46
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $118.44 / $118.44 / $118.44	Professional	26	$118.44	$118.44	$118.44
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,001.01 / $1,001.01 / $1,001.01	Professional	TC	$1,001.01	$1,001.01	$1,001.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $314.54 / $407.41 / $494.71	Professional		$314.54	$407.41	$494.71
United Facility/Professional Professional Modifier Low / Median / High Price $274.25 / $372.37 / $1,016.27	Professional		$274.25	$372.37	$1,016.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $37.17 / $99.88	Professional	26	$29.27	$37.17	$99.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.98 / $358.66 / $975.13	Professional	TC	$244.98	$358.66	$975.13