Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.11 / $96.25 / $336.89	Professional		$66.11	$96.25	$336.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $17.30 / $76.95	Professional	26	$15.09	$17.30	$76.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.59 / $78.93 / $259.93	Professional	TC	$50.59	$78.93	$259.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.94 / $95.85 / $200.64	Professional		$67.94	$95.85	$200.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $25.19 / $50.69	Professional	26	$20.00	$25.19	$50.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.57 / $70.47 / $149.94	Professional	TC	$46.57	$70.47	$149.94
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $101.71 / $211.59	Professional		$81.17	$101.71	$211.59
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.75 / $22.61 / $52.22	Professional	26	$17.75	$22.61	$52.22
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $64.01 / $81.72 / $162.55	Professional	TC	$64.01	$81.72	$162.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $109.87 / $300.76	Professional		$75.06	$109.87	$300.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $23.71 / $50.45	Professional	26	$16.55	$23.71	$50.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.13 / $87.40 / $238.79	Professional	TC	$54.13	$87.40	$238.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $52.72 / $146.00 / $197.10	Professional		$52.72	$146.00	$197.10
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $21.01 / $28.36	Professional	26	$11.60	$21.01	$28.36
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.12 / $124.99 / $168.74	Professional	TC	$41.12	$124.99	$168.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.85 / $143.41 / $230.68	Professional		$108.85	$143.41	$230.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $25.21 / $39.50	Professional	26	$18.48	$25.21	$39.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $99.99 / $144.53 / $234.35	Professional	TC	$99.99	$144.53	$234.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $751.09 / $751.09 / $924.90	Professional		$751.09	$751.09	$924.90
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $205.00 / $205.00 / $205.00	Professional	26	$205.00	$205.00	$205.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $630.88 / $630.88 / $773.40	Professional	TC	$630.88	$630.88	$773.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $90.26	Professional		$32.34	$32.34	$90.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.20 / $145.00 / $312.68	Professional		$77.20	$145.00	$312.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $23.30 / $49.68	Professional	26	$16.55	$23.30	$49.68
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $53.21 / $84.22 / $223.43	Professional	TC	$53.21	$84.22	$223.43
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $363.73 / $363.73 / $363.73	Professional		$363.73	$363.73	$363.73
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Professional	26	$61.34	$61.34	$61.34
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $302.38 / $302.38 / $302.38	Professional	TC	$302.38	$302.38	$302.38
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $79.06 / $128.55 / $162.37	Professional		$79.06	$128.55	$162.37
United Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $110.43 / $279.24	Professional		$55.86	$110.43	$279.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.66 / $20.05 / $46.23	Professional	26	$14.66	$20.05	$46.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.50 / $90.94 / $227.28	Professional	TC	$41.50	$90.94	$227.28