Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $89.13 / $489.78	Facility	26	$81.28	$89.13	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $1,071.52	Professional		$363.08	$436.52	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $134.90 / $416.87	Professional	26	$81.28	$134.90	$416.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $354.81 / $831.76	Professional	TC	$269.15	$354.81	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $446.68 / $457.09	Professional		$407.38	$446.68	$457.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $123.03	Professional	26	$95.50	$95.50	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $363.08 / $954.99	Professional		$213.80	$363.08	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $120.23 / $239.88	Professional	26	$81.28	$120.23	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $257.04 / $758.58	Professional	TC	$91.20	$257.04	$758.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $870.96	Professional		$281.84	$407.38	$870.96
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $100.00 / $194.98	Professional	26	$75.86	$100.00	$194.98
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $288.40 / $645.65	Professional	TC	$190.55	$288.40	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $537.03 / $1,174.90	Professional		$309.03	$537.03	$1,174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $112.20 / $234.42	Professional	26	$87.10	$112.20	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $426.58 / $954.99	Professional	TC	$218.78	$426.58	$954.99
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $812.83	Professional		$107.15	$141.25	$812.83
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $85.11 / $131.83	Professional	26	$64.57	$85.11	$131.83
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $56.23 / $691.83	Professional	TC	$42.66	$56.23	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $588.84 / $977.24	Professional		$489.78	$588.84	$977.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $95.50 / $162.18	Professional	26	$85.11	$95.50	$162.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $501.19 / $831.76	Professional	TC	$426.58	$501.19	$831.76
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	26	$537.03	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,715.35 / $3,715.35	Professional		$2,754.23	$3,715.35	$3,715.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $676.08 / $676.08 / $776.25	Professional	26	$676.08	$676.08	$776.25
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,187.76 / $3,019.95 / $3,019.95	Professional	TC	$2,187.76	$3,019.95	$3,019.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $478.63 / $602.56	Professional		$120.23	$478.63	$602.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $1,122.02	Professional		$323.59	$549.54	$1,122.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $112.20 / $213.80	Professional	26	$87.10	$112.20	$213.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $426.58 / $851.14	Professional	TC	$223.87	$426.58	$851.14
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $288.40 / $288.40	Professional	26	$288.40	$288.40	$288.40
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional	TC	$1,096.48	$1,096.48	$1,096.48
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $549.54	Professional		$134.90	$229.09	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $977.24	Professional		$288.40	$416.87	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $208.93	Professional	26	$70.79	$93.33	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $323.59 / $776.25	Professional	TC	$208.93	$323.59	$776.25