Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.52 / $52.49 / $341.82	Facility	26	$48.52	$52.49	$341.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $164.74 / $721.00	Professional		$145.34	$164.74	$721.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $60.65 / $256.87	Professional	26	$43.93	$60.65	$256.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $112.25 / $456.29	Professional	TC	$96.82	$112.25	$456.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.57 / $95.57 / $311.42	Professional		$95.57	$95.57	$311.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.77 / $68.26 / $260.24	Professional	26	$20.77	$68.26	$260.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $191.72 / $478.31	Professional		$73.44	$191.72	$478.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $72.45 / $143.38	Professional	26	$22.60	$72.45	$143.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $121.69 / $346.70	Professional	TC	$21.48	$121.69	$346.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $108.51 / $158.93 / $397.40	Professional		$108.51	$158.93	$397.40
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.66 / $57.47 / $133.13	Professional	26	$47.66	$57.47	$133.13
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $79.30 / $99.56 / $264.38	Professional	TC	$79.30	$99.56	$264.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $109.72 / $412.63	Professional		$79.81	$109.72	$412.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.66 / $31.49 / $114.93	Professional	26	$22.66	$31.49	$114.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.61 / $77.95 / $282.79	Professional	TC	$47.61	$77.95	$282.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $87.58 / $229.23 / $309.45	Professional		$87.58	$229.23	$309.45
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $47.18 / $63.69	Professional	26	$18.39	$47.18	$63.69
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.19 / $182.05 / $245.77	Professional	TC	$69.19	$182.05	$245.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.11 / $226.31 / $393.93	Professional		$177.11	$226.31	$393.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.43 / $56.62 / $98.21	Professional	26	$38.43	$56.62	$98.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.47 / $213.53 / $341.41	Professional	TC	$134.47	$213.53	$341.41
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $99.23 / $239.31 / $239.31	Facility	26	$99.23	$239.31	$239.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,140.80 / $1,140.80 / $1,458.60	Professional		$1,140.80	$1,140.80	$1,458.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $326.98 / $330.05 / $330.38	Professional	26	$326.98	$330.05	$330.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $871.18 / $871.18 / $1,128.23	Professional	TC	$871.18	$871.18	$1,128.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $151.71 / $201.17	Professional		$49.46	$151.71	$201.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.49 / $194.77 / $497.00	Professional		$85.49	$194.77	$497.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.73 / $35.36 / $125.71	Professional	26	$23.73	$35.36	$125.71
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.61 / $86.44 / $380.00	Professional	TC	$41.61	$86.44	$380.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $688.89 / $688.89 / $688.89	Professional		$688.89	$688.89	$688.89
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $167.14 / $167.14 / $167.14	Professional	26	$167.14	$167.14	$167.14
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $521.74 / $521.74 / $521.74	Professional	TC	$521.74	$521.74	$521.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $148.88 / $208.60	Professional		$89.33	$148.88	$208.60
United Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $111.45 / $525.20	Professional		$87.32	$111.45	$525.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $35.18 / $124.28	Professional	26	$27.50	$35.18	$124.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.95 / $82.94 / $400.92	Professional	TC	$59.95	$82.94	$400.92