Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $41.69 / $114.82	Facility	26	$20.89	$41.69	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $154.88	Professional		$38.02	$61.66	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.99 / $83.18	Professional	26	$19.05	$23.99	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $32.36 / $69.18	Professional	TC	$16.98	$32.36	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $54.95 / $58.88	Professional		$47.86	$54.95	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $29.51 / $43.65	Professional	26	$29.51	$29.51	$43.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $141.25	Professional		$43.65	$66.07	$141.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $66.07	Professional	26	$23.99	$35.48	$66.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $77.62	Professional	TC	$19.05	$30.20	$77.62
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $117.49	Professional		$37.15	$48.98	$117.49
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.92 / $58.88	Professional	26	$19.95	$26.92	$58.88
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.39 / $58.88	Professional	TC	$16.60	$22.39	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $33.11	Facility	26	$4.90	$22.91	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $154.88	Professional		$43.65	$63.10	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $29.51 / $64.57	Professional	26	$22.39	$29.51	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $33.88 / $97.72	Professional	TC	$19.50	$33.88	$97.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $97.72	Professional		$38.02	$72.44	$97.72
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $24.55 / $31.62	Professional	26	$20.42	$24.55	$31.62
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $50.12 / $67.61	Professional	TC	$17.38	$50.12	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $66.07 / $117.49	Professional		$53.70	$66.07	$117.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.38 / $38.02	Professional	26	$19.05	$21.38	$38.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $44.67 / $77.62	Professional	TC	$37.15	$44.67	$77.62
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $457.09 / $457.09	Professional		$380.19	$457.09	$457.09
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $162.18 / $162.18	Professional	26	$128.82	$162.18	$162.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $302.00 / $302.00	Professional	TC	$239.88	$302.00	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $77.62	Professional		$28.84	$47.86	$77.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $66.07 / $151.36	Professional		$44.67	$66.07	$151.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $29.51 / $57.54	Professional	26	$22.91	$29.51	$57.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $33.11 / $75.86	Professional	TC	$19.50	$33.11	$75.86
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	26	$69.18	$69.18	$69.18
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	TC	$95.50	$95.50	$95.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $69.18	Professional		$38.02	$60.26	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $50.12 / $114.82	Professional		$35.48	$50.12	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $24.55 / $48.98	Professional	26	$16.98	$24.55	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $64.57	Professional	TC	$15.85	$25.70	$64.57