Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $588.84	Professional		$44.67	$58.88	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.88 / $169.82	Professional	26	$16.98	$21.88	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.90 / $426.58	Professional	TC	$25.70	$38.90	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	26	$63.10	$63.10	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $63.10 / $213.80	Professional		$35.48	$63.10	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.11 / $83.18	Professional	26	$24.55	$33.11	$83.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $32.36 / $134.90	Professional	TC	$9.12	$32.36	$134.90
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $162.18	Professional		$53.70	$72.44	$162.18
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $34.67 / $81.28	Professional	26	$26.92	$34.67	$81.28
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.02 / $89.13	Professional	TC	$28.84	$38.02	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $134.90	Professional		$30.20	$42.66	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $46.77	Professional	26	$12.88	$15.14	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $27.54 / $91.20	Professional	TC	$17.78	$27.54	$91.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $109.65 / $147.91	Professional		$20.89	$109.65	$147.91
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.18 / $38.02	Professional	26	$16.60	$28.18	$38.02
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.17 / $83.18 / $112.20	Professional	TC	$4.17	$83.18	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $165.96	Professional		$85.11	$104.71	$165.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.11 / $42.66	Professional	26	$22.91	$33.11	$42.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $89.13 / $123.03	Professional	TC	$61.66	$89.13	$123.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $707.95 / $707.95	Professional		$467.74	$707.95	$707.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $199.53 / $199.53	Professional	26	$186.21	$199.53	$199.53
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $501.19 / $501.19	Professional	TC	$309.03	$501.19	$501.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $57.54 / $190.55	Professional		$31.62	$57.54	$190.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.05 / $54.95	Professional	26	$12.88	$19.05	$54.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $30.90 / $91.20	Professional	TC	$17.78	$30.90	$91.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	26	$95.50	$95.50	$95.50
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	TC	$162.18	$162.18	$162.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $123.03	Professional		$91.20	$91.20	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $181.97	Professional		$33.88	$46.77	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.60 / $63.10	Professional	26	$14.45	$16.60	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $31.62 / $125.89	Professional	TC	$19.05	$31.62	$125.89