Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.04 / $80.69 / $479.97	Facility	26	$72.04	$80.69	$479.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $161.46 / $568.17	Professional		$131.13	$161.46	$568.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.22 / $81.73 / $302.00	Professional	26	$71.22	$81.73	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.36 / $62.30 / $116.47	Professional	TC	$53.36	$62.30	$116.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $128.72 / $264.64	Professional		$112.84	$128.72	$264.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.78 / $89.80 / $148.65	Professional	26	$67.78	$89.80	$148.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.91 / $190.70 / $396.20	Professional		$125.91	$190.70	$396.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $102.13 / $209.64	Professional	26	$69.84	$102.13	$209.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.03 / $89.02 / $186.55	Professional	TC	$54.03	$89.02	$186.55
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $99.46 / $132.62 / $316.55	Professional		$99.46	$132.62	$316.55
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $62.41 / $86.49 / $124.07	Professional	26	$62.41	$86.49	$124.07
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $58.91 / $79.45 / $123.58	Professional	TC	$58.91	$79.45	$123.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.69 / $186.32 / $423.97	Professional		$117.69	$186.32	$423.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.84 / $105.95 / $233.41	Professional	26	$82.84	$105.95	$233.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.67 / $89.80 / $207.84	Professional	TC	$66.67	$89.80	$207.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $164.27 / $221.76	Professional		$122.34	$164.27	$221.76
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.06 / $88.85 / $119.95	Professional	26	$66.06	$88.85	$119.95
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.28 / $75.42 / $101.82	Professional	TC	$56.28	$75.42	$101.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.23 / $159.47 / $299.51	Professional		$127.23	$159.47	$299.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $73.28 / $89.79 / $160.37	Professional	26	$73.28	$89.79	$160.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.16 / $75.42 / $136.13	Professional	TC	$58.16	$75.42	$136.13
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $180.18 / $351.19 / $386.70	Facility	26	$180.18	$351.19	$386.70
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $874.03 / $874.03 / $1,093.34	Professional		$874.03	$874.03	$1,093.34
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $497.06 / $497.06 / $625.42	Professional	26	$497.06	$497.06	$625.42
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $376.97 / $376.97 / $467.93	Professional	TC	$376.97	$376.97	$467.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $186.97	Professional		$32.34	$32.34	$186.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.02 / $208.57 / $370.29	Professional		$147.02	$208.57	$370.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $83.04 / $106.58 / $216.83	Professional	26	$83.04	$106.58	$216.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $91.88 / $192.99	Professional	TC	$68.81	$91.88	$192.99
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $483.87 / $483.87 / $483.87	Professional		$483.87	$483.87	$483.87
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $265.63 / $265.63 / $265.63	Professional	26	$265.63	$265.63	$265.63
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $218.23 / $218.23 / $218.23	Professional	TC	$218.23	$218.23	$218.23
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $132.84 / $159.05 / $207.98	Professional		$132.84	$159.05	$207.98
United Facility/Professional Professional Modifier Low / Median / High Price $115.36 / $162.65 / $415.26	Professional		$115.36	$162.65	$415.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $88.85 / $239.41	Professional	26	$64.40	$88.85	$239.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.40 / $70.98 / $184.62	Professional	TC	$50.40	$70.98	$184.62