Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.50 / $35.94 / $190.19	Facility	26	$32.50	$35.94	$190.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $63.87 / $164.95	Professional		$50.29	$63.87	$164.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.38 / $35.94 / $90.34	Professional	26	$29.38	$35.94	$90.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $23.19 / $61.73	Professional	TC	$18.03	$23.19	$61.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.08 / $65.08 / $154.13	Professional		$65.08	$65.08	$154.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $96.05 / $182.70	Professional		$67.14	$96.05	$182.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.27 / $61.10 / $107.95	Professional	26	$34.27	$61.10	$107.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.74 / $36.11 / $74.83	Professional	TC	$26.74	$36.11	$74.83
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $56.64 / $80.48 / $173.96	Professional		$56.64	$80.48	$173.96
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $50.81 / $102.17	Professional	26	$35.79	$50.81	$102.17
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.76 / $29.41 / $72.27	Professional	TC	$20.76	$29.41	$72.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.10 / $35.10 / $35.10	Facility	26	$35.10	$35.10	$35.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $80.83 / $205.36	Professional		$55.22	$80.83	$205.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.01 / $45.61 / $109.93	Professional	26	$34.01	$45.61	$109.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $35.89 / $106.53	Professional	TC	$20.25	$35.89	$106.53
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $83.44 / $112.64	Professional		$48.79	$83.44	$112.64
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.74 / $36.89 / $46.76	Professional	26	$30.74	$36.89	$46.76
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $48.80 / $65.88	Professional	TC	$18.05	$48.80	$65.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.65 / $77.00 / $159.13	Professional		$61.65	$77.00	$159.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.31 / $34.64 / $75.52	Professional	26	$28.31	$34.64	$75.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.84 / $48.80 / $106.38	Professional	TC	$35.84	$48.80	$106.38
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $72.78 / $121.17 / $152.05	Facility	26	$72.78	$121.17	$152.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $486.90 / $486.90 / $550.58	Professional		$486.90	$486.90	$550.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $196.52 / $196.52 / $246.68	Professional	26	$196.52	$196.52	$246.68
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.63 / $244.63 / $303.83	Professional	TC	$244.63	$244.63	$303.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $43.78 / $92.97	Professional		$32.34	$43.78	$92.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $35.10 / $35.10 / $35.10	Facility	26	$35.10	$35.10	$35.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.70 / $87.96 / $184.19	Professional		$57.70	$87.96	$184.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $44.31 / $87.85	Professional	26	$34.15	$44.31	$87.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $33.79 / $79.27	Professional	TC	$20.25	$33.79	$79.27
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $201.84 / $201.84 / $201.84	Professional		$201.84	$201.84	$201.84
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $106.22 / $106.22 / $106.22	Professional	26	$106.22	$106.22	$106.22
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $95.61 / $95.61 / $95.61	Professional	TC	$95.61	$95.61	$95.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $73.19 / $92.77	Professional		$63.43	$73.19	$92.77
United Facility/Professional Professional Modifier Low / Median / High Price $44.70 / $61.12 / $151.09	Professional		$44.70	$61.12	$151.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.76 / $36.02 / $82.80	Professional	26	$25.76	$36.02	$82.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $26.40 / $72.00	Professional	TC	$16.77	$26.40	$72.00