Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.40 / $49.08 / $220.32	Facility	26	$44.40	$49.08	$220.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.28 / $73.09 / $201.60	Professional		$65.28	$73.09	$201.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.75 / $48.19 / $123.43	Professional	26	$36.75	$48.19	$123.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $27.52 / $62.74	Professional	TC	$21.05	$27.52	$62.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.50 / $69.79 / $90.93	Professional		$67.50	$69.79	$90.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $90.18 / $182.95	Professional		$68.81	$90.18	$182.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $59.72 / $114.95	Professional	26	$41.66	$59.72	$114.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $30.61 / $72.33	Professional	TC	$21.33	$30.61	$72.33
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $64.90 / $145.00	Professional		$45.68	$64.90	$145.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $28.82 / $41.17 / $100.00	Professional	26	$28.82	$41.17	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $23.66 / $60.24	Professional	TC	$16.78	$23.66	$60.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.66 / $92.25 / $253.33	Professional		$68.66	$92.25	$253.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.27 / $56.29 / $134.57	Professional	26	$42.27	$56.29	$134.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $37.36 / $106.53	Professional	TC	$22.89	$37.36	$106.53
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $58.20 / $88.02 / $118.83	Professional		$58.20	$88.02	$118.83
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.25 / $43.65 / $53.57	Professional	26	$37.25	$43.65	$53.57
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.95 / $48.34 / $65.26	Professional	TC	$20.95	$48.34	$65.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $81.54 / $184.00	Professional		$65.50	$81.54	$184.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.49 / $39.68 / $86.50	Professional	26	$32.49	$39.68	$86.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.50 / $48.34 / $101.50	Professional	TC	$35.50	$48.34	$101.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.68 / $83.68 / $176.34	Facility	26	$83.68	$83.68	$176.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $568.04 / $568.04 / $586.04	Professional		$568.04	$568.04	$586.04
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $234.92 / $234.92 / $285.00	Professional	26	$234.92	$234.92	$285.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.63 / $244.63 / $301.05	Professional	TC	$244.63	$244.63	$301.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.74 / $99.79	Professional		$32.34	$48.74	$99.79
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $71.28 / $98.89 / $198.55	Professional		$71.28	$98.89	$198.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $42.27 / $55.91 / $121.17	Professional	26	$42.27	$55.91	$121.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $35.61 / $81.43	Professional	TC	$23.31	$35.61	$81.43
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $218.81 / $218.81 / $218.81	Professional		$218.81	$218.81	$218.81
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $123.20 / $123.20 / $123.20	Professional	26	$123.20	$123.20	$123.20
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 $71.17 / $80.06 / $98.95	Professional		$71.17	$80.06	$98.95
United Facility/Professional Professional Modifier Low / Median / High Price $51.71 / $71.45 / $163.57	Professional		$51.71	$71.45	$163.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.38 / $44.76 / $96.31	Professional	26	$30.38	$44.76	$96.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $27.45 / $73.48	Professional	TC	$18.70	$27.45	$73.48