Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $87.10 / $229.09	Facility	26	$44.67	$87.10	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $245.47	Professional		$70.79	$95.50	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $208.93	Professional	26	$40.74	$56.23	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $42.66 / $91.20	Professional	TC	$25.12	$42.66	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $81.28	Professional		$77.62	$77.62	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	26	$35.48	$35.48	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $223.87	Professional		$79.43	$114.82	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $72.44 / $134.90	Professional	26	$50.12	$72.44	$134.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $40.74 / $97.72	Professional	TC	$26.92	$40.74	$97.72
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $263.03	Professional		$93.33	$125.89	$263.03
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $165.96	Professional	26	$60.26	$83.18	$165.96
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.67 / $104.71	Professional	TC	$33.11	$44.67	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $45.71 / $66.07	Facility	26	$10.00	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $245.47	Professional		$77.62	$104.71	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $61.66 / $131.83	Professional	26	$46.77	$61.66	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $114.82	Professional	TC	$26.92	$44.67	$114.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $144.54	Professional		$67.61	$107.15	$144.54
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $64.57	Professional	26	$43.65	$52.48	$64.57
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $58.88 / $79.43	Professional	TC	$24.55	$58.88	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $213.80	Professional		$79.43	$95.50	$213.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $43.65 / $75.86	Professional	26	$38.90	$43.65	$75.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $53.70 / $91.20	Professional	TC	$43.65	$53.70	$91.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $323.59 / $323.59	Professional	26	$269.15	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $354.81 / $354.81	Professional	TC	$288.40	$354.81	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $114.82	Professional		$57.54	$57.54	$114.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $229.09	Professional		$79.43	$109.65	$229.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $114.82	Professional	26	$47.86	$61.66	$114.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $42.66 / $93.33	Professional	TC	$27.54	$42.66	$93.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	TC	$114.82	$114.82	$114.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $120.23	Professional		$67.61	$95.50	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $177.83	Professional		$58.88	$83.18	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $50.12 / $100.00	Professional	26	$34.67	$50.12	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $79.43	Professional	TC	$22.39	$33.11	$79.43