Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.08 / $75.00 / $172.40	Professional		$51.08	$75.00	$172.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.60 / $98.01	Professional	26	$19.95	$25.60	$98.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.28 / $55.87 / $90.98	Professional	TC	$41.28	$55.87	$90.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.28 / $34.28 / $34.28	Professional		$34.28	$34.28	$34.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $38.25 / $108.55	Professional	26	$10.69	$38.25	$108.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.59 / $23.59 / $23.59	Professional	TC	$23.59	$23.59	$23.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $84.43 / $181.11	Professional		$40.90	$84.43	$181.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $35.18 / $67.83	Professional	26	$24.28	$35.18	$67.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.00 / $50.27 / $113.47	Professional	TC	$12.00	$50.27	$113.47
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.02 / $79.73 / $194.38	Professional		$60.02	$79.73	$194.38
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $35.42 / $100.00	Professional	26	$25.24	$35.42	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $34.78 / $44.32 / $106.44	Professional	TC	$34.78	$44.32	$106.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.68 / $111.68 / $111.68	Facility		$111.68	$111.68	$111.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.67 / $47.09 / $147.31	Professional		$33.67	$47.09	$147.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $14.78 / $49.52	Professional	26	$11.40	$14.78	$49.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $30.93 / $95.46	Professional	TC	$21.27	$30.93	$95.46
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $91.05 / $122.92	Professional		$28.92	$91.05	$122.92
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $24.81 / $33.49	Professional	26	$23.14	$24.81	$33.49
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.78 / $66.23 / $89.42	Professional	TC	$5.78	$66.23	$89.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $84.86 / $137.59	Professional		$70.76	$84.86	$137.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $29.77 / $37.22	Professional	26	$19.85	$29.77	$37.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.94 / $79.19 / $99.36	Professional	TC	$48.94	$79.19	$99.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $154.82 / $317.91 / $373.45	Facility		$154.82	$317.91	$373.45
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $51.35 / $113.52 / $113.52	Facility	26	$51.35	$113.52	$113.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $407.64 / $407.64 / $585.60	Professional		$407.64	$407.64	$585.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $244.00 / $244.00 / $244.00	Professional	26	$244.00	$244.00	$244.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $268.50 / $268.50 / $411.38	Professional	TC	$268.50	$268.50	$411.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $42.01 / $74.23	Professional		$25.70	$42.01	$74.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.12 / $88.20 / $124.27	Facility		$64.12	$88.20	$124.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.51 / $81.48 / $179.55	Professional		$34.51	$81.48	$179.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $15.77 / $63.52	Professional	26	$11.43	$15.77	$63.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.41 / $30.93 / $104.27	Professional	TC	$21.41	$30.93	$104.27
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $235.20 / $235.20 / $235.20	Professional		$235.20	$235.20	$235.20
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $85.62 / $85.62 / $85.62	Professional	26	$85.62	$85.62	$85.62
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $149.57 / $149.57 / $149.57	Professional	TC	$149.57	$149.57	$149.57
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $73.64 / $101.26	Professional		$73.64	$73.64	$101.26
United Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $43.36 / $142.85	Professional		$37.90	$43.36	$142.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.44 / $16.59 / $58.70	Professional	26	$13.44	$16.59	$58.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $29.61 / $104.27	Professional	TC	$23.82	$29.61	$104.27