Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.41 / $53.47 / $148.96	Professional		$46.41	$53.47	$148.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $22.61 / $88.58	Professional	26	$18.37	$22.61	$88.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $31.64 / $109.46	Professional	TC	$26.60	$31.64	$109.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.67 / $61.46 / $163.27	Professional		$32.67	$61.46	$163.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.26 / $31.13 / $67.95	Professional	26	$23.26	$31.13	$67.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.72 / $31.30 / $100.68	Professional	TC	$8.72	$31.30	$100.68
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $44.77 / $60.11 / $146.53	Professional		$44.77	$60.11	$146.53
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $22.25 / $31.51 / $90.36	Professional	26	$22.25	$31.51	$90.36
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $28.60 / $81.18	Professional	TC	$22.35	$28.60	$81.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $45.26 / $143.74	Professional		$28.59	$45.26	$143.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $15.71 / $51.78	Professional	26	$12.65	$15.71	$51.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.99 / $28.64 / $92.85	Professional	TC	$14.99	$28.64	$92.85
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $31.95 / $108.45 / $146.41	Professional		$31.95	$108.45	$146.41
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.56 / $28.76 / $38.83	Professional	26	$25.56	$28.76	$38.83
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.39 / $79.69 / $107.58	Professional	TC	$6.39	$79.69	$107.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.25 / $101.04 / $163.82	Professional		$84.25	$101.04	$163.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.01 / $34.51 / $43.14	Professional	26	$23.01	$34.51	$43.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.89 / $95.37 / $119.54	Professional	TC	$58.89	$95.37	$119.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.11 / $113.54 / $125.12	Facility	26	$59.11	$113.54	$125.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $453.03 / $453.03 / $698.48	Professional		$453.03	$453.03	$698.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $201.08	Professional	26	$158.49	$158.49	$201.08
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $300.38 / $300.38 / $497.40	Professional	TC	$300.38	$300.38	$497.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.61 / $49.23 / $84.48	Professional		$29.61	$49.23	$84.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $70.56 / $200.75	Professional		$29.58	$70.56	$200.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $16.42 / $65.83	Professional	26	$12.65	$16.42	$65.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $30.45 / $105.40	Professional	TC	$14.84	$30.45	$105.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $270.36 / $270.36 / $270.36	Professional		$270.36	$270.36	$270.36
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $98.93 / $98.93 / $98.93	Professional	26	$98.93	$98.93	$98.93
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $171.42 / $171.42 / $171.42	Professional	TC	$171.42	$171.42	$171.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $87.71 / $87.71 / $120.60	Professional		$87.71	$87.71	$120.60
United Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $45.55 / $159.58	Professional		$30.97	$45.55	$159.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $16.78 / $73.67	Professional	26	$14.50	$16.78	$73.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.37 / $29.34 / $130.87	Professional	TC	$16.37	$29.34	$130.87