Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.05 / $83.04 / $489.24	Facility	26	$75.05	$83.04	$489.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $157.44 / $514.00	Professional		$130.08	$157.44	$514.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.70 / $83.21 / $208.63	Professional	26	$72.70	$83.21	$208.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.39 / $73.81 / $130.10	Professional	TC	$51.39	$73.81	$130.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $135.78 / $135.78	Professional		$135.78	$135.78	$135.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.45 / $74.59 / $356.61	Professional	26	$67.45	$74.59	$356.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $167.58 / $296.68	Professional		$109.87	$167.58	$296.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.94 / $99.25 / $198.12	Professional	26	$67.94	$99.25	$198.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.04 / $58.13 / $135.57	Professional	TC	$37.04	$58.13	$135.57
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.53 / $311.72	Professional		$100.00	$128.53	$311.72
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $54.29 / $74.72 / $177.82	Professional	26	$54.29	$74.72	$177.82
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $31.67 / $41.55 / $105.96	Professional	TC	$31.67	$41.55	$105.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.15 / $189.89 / $477.42	Professional		$113.15	$189.89	$477.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.20 / $105.03 / $233.81	Professional	26	$81.20	$105.03	$233.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.29 / $107.98 / $255.53	Professional	TC	$40.29	$107.98	$255.53
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $98.40 / $124.80 / $261.04	Professional		$98.40	$124.80	$261.04
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.75 / $90.40 / $122.04	Professional	26	$76.75	$90.40	$122.04
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $27.46 / $139.00	Professional	TC	$21.65	$27.46	$139.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $189.84 / $360.21	Professional		$148.80	$189.84	$360.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.64 / $91.35 / $163.16	Professional	26	$74.64	$91.35	$163.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.38 / $102.96 / $185.84	Professional	TC	$79.38	$102.96	$185.84
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $183.99 / $358.77 / $394.16	Facility	26	$183.99	$358.77	$394.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,053.48 / $1,053.48 / $1,277.48	Professional		$1,053.48	$1,053.48	$1,277.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $509.36 / $509.36 / $639.83	Professional	26	$509.36	$509.36	$639.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $544.05 / $544.05 / $637.65	Professional	TC	$544.05	$544.05	$637.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $221.17	Professional		$32.34	$32.34	$221.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $226.67 / $440.27	Professional		$130.63	$226.67	$440.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $81.20 / $105.20 / $221.37	Professional	26	$81.20	$105.20	$221.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.29 / $108.14 / $239.09	Professional	TC	$40.29	$108.14	$239.09
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $572.72 / $572.72 / $572.72	Professional		$572.72	$572.72	$572.72
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $271.52 / $271.52 / $271.52	Professional	26	$271.52	$271.52	$271.52
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $301.18 / $301.18 / $301.18	Professional	TC	$301.18	$301.18	$301.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $124.80 / $183.49 / $254.06	Professional		$124.80	$183.49	$254.06
United Facility/Professional Professional Modifier Low / Median / High Price $116.75 / $170.68 / $435.89	Professional		$116.75	$170.68	$435.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.08 / $89.43 / $225.08	Professional	26	$66.08	$89.43	$225.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.69 / $87.85 / $240.37	Professional	TC	$40.69	$87.85	$240.37