Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $45.71 / $251.19	Facility	26	$40.74	$45.71	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $177.83	Professional		$72.44	$85.11	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $45.71 / $104.71	Professional	26	$39.81	$45.71	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $42.66 / $100.00	Professional	TC	$34.67	$42.66	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $85.11 / $95.50	Professional		$81.28	$85.11	$95.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $199.53	Professional		$60.26	$87.10	$199.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $51.29 / $117.49	Professional	26	$38.02	$51.29	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $93.33	Professional	TC	$20.89	$33.88	$93.33
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $190.55	Professional		$64.57	$91.20	$190.55
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $100.00	Professional	26	$38.02	$50.12	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $81.28	Professional	TC	$20.89	$32.36	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $229.09	Professional		$69.18	$104.71	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $57.54 / $120.23	Professional	26	$44.67	$57.54	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $51.29 / $114.82	Professional	TC	$23.44	$51.29	$114.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $158.49	Professional		$117.49	$128.82	$158.49
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $57.54 / $70.79	Professional	26	$52.48	$57.54	$70.79
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $70.79 / $87.10	Professional	TC	$64.57	$70.79	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $177.83	Professional		$89.13	$104.71	$177.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $47.86 / $79.43	Professional	26	$42.66	$47.86	$79.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $58.88 / $97.72	Professional	TC	$50.12	$58.88	$97.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	26	$281.84	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $707.95 / $707.95	Professional		$562.34	$707.95	$707.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $346.74 / $346.74	Professional	26	$316.23	$346.74	$346.74
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $363.08 / $363.08	Professional	TC	$316.23	$363.08	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $63.10 / $123.03	Professional		$58.88	$63.10	$123.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $229.09	Professional		$74.13	$109.65	$229.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $57.54 / $112.20	Professional	26	$44.67	$57.54	$112.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $51.29 / $100.00	Professional	TC	$22.91	$51.29	$100.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Professional		$288.40	$288.40	$288.40
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	26	$147.91	$147.91	$147.91
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	TC	$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $194.98	Professional		$64.57	$87.10	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $47.86 / $104.71	Professional	26	$36.31	$47.86	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $39.81 / $97.72	Professional	TC	$26.92	$39.81	$97.72