Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.47 / $37.29 / $133.12	Facility	26	$33.47	$37.29	$133.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.39 / $115.98 / $193.00	Professional		$33.39	$115.98	$193.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.92 / $33.46 / $106.00	Professional	26	$18.92	$33.46	$106.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.46 / $88.56 / $111.41	Professional	TC	$14.46	$88.56	$111.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $112.72 / $211.17	Professional		$43.68	$112.72	$211.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $38.60 / $87.31	Professional	26	$23.54	$38.60	$87.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.77 / $65.52 / $153.09	Professional	50	$40.77	$65.52	$153.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $72.13 / $133.88	Professional	TC	$19.11	$72.13	$133.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $135.60 / $302.14	Professional		$100.00	$135.60	$302.14
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $34.97 / $84.19	Professional	26	$26.94	$34.97	$84.19
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $69.15 / $102.56 / $224.57	Professional	TC	$69.15	$102.56	$224.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $94.62 / $192.66	Professional		$40.86	$94.62	$192.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.13 / $36.49 / $62.90	Professional	26	$23.13	$36.49	$62.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $42.09 / $135.85	Professional	TC	$17.51	$42.09	$135.85
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $48.33 / $53.16 / $65.25	Professional		$48.33	$53.16	$65.25
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.32 / $26.75 / $32.83	Professional	26	$24.32	$26.75	$32.83
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $26.41 / $32.40	Professional	TC	$24.01	$26.41	$32.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $48.33 / $89.00	Professional		$37.27	$48.33	$89.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.08 / $29.18 / $45.72	Professional	26	$21.08	$29.18	$45.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $27.86 / $45.14	Professional	TC	$19.21	$27.86	$45.14
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $201.45 / $201.45	Facility	26	$100.00	$201.45	$201.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $764.92 / $787.87 / $787.87	Professional		$764.92	$787.87	$787.87
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $203.00 / $382.94 / $382.94	Professional	26	$203.00	$382.94	$382.94
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $585.86 / $603.44 / $603.44	Professional	TC	$585.86	$603.44	$603.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.03 / $32.34 / $32.34	Professional		$30.03	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $91.93 / $180.08	Professional		$43.02	$91.93	$180.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $37.63 / $60.85	Professional	26	$23.21	$37.63	$60.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $45.41 / $138.05	Professional	TC	$17.66	$45.41	$138.05
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $129.11 / $129.11 / $129.11	Professional		$129.11	$129.11	$129.11
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $73.17 / $73.17 / $73.17	Professional	26	$73.17	$73.17	$73.17
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $55.94 / $55.94 / $55.94	Professional	TC	$55.94	$55.94	$55.94
United Facility/Professional Professional Modifier Low / Median / High Price $31.90 / $60.30 / $157.44	Professional		$31.90	$60.30	$157.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $28.70 / $66.02	Professional	26	$18.27	$28.70	$66.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.63 / $23.96 / $97.41	Professional	TC	$13.63	$23.96	$97.41