Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.38 / $26.41 / $73.41	Professional		$22.38	$26.41	$73.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $21.84 / $121.94	Professional	26	$16.30	$21.84	$121.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.55 / $6.55 / $16.38	Professional	TC	$5.55	$6.55	$16.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $16.07 / $16.07	Professional		$16.07	$16.07	$16.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.76 / $34.76 / $34.76	Professional	26	$34.76	$34.76	$34.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.54 / $33.53 / $73.98	Professional		$25.54	$33.53	$73.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.11 / $25.38 / $54.25	Professional	26	$19.11	$25.38	$54.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.43 / $8.19 / $19.19	Professional	TC	$6.43	$8.19	$19.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $24.12 / $33.97 / $97.87	Professional		$24.12	$33.97	$97.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.75 / $25.02 / $64.61	Professional	26	$17.75	$25.02	$64.61
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $6.36 / $8.69 / $24.56	Professional	TC	$6.36	$8.69	$24.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.71 / $18.67 / $63.75	Professional		$14.71	$18.67	$63.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $13.45 / $48.07	Professional	26	$11.05	$13.45	$48.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.63 / $5.03 / $15.70	Professional	TC	$3.63	$5.03	$15.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $36.04 / $48.65	Professional		$21.74	$36.04	$48.65
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.78 / $24.10 / $32.54	Professional	26	$4.78	$24.10	$32.54
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.93 / $16.11 / $16.96	Professional	TC	$11.93	$16.11	$16.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $34.88 / $55.86	Professional		$28.94	$34.88	$55.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.28 / $28.92 / $36.17	Professional	26	$19.28	$28.92	$36.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $8.82 / $14.24 / $17.89	Professional	TC	$8.82	$14.24	$17.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.43 / $95.38 / $104.98	Facility	26	$70.43	$95.38	$104.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $180.45 / $180.45 / $242.63	Professional		$180.45	$180.45	$242.63
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.87 / $134.87 / $169.13	Professional	26	$134.87	$134.87	$169.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.58 / $45.58 / $73.58	Professional	TC	$45.58	$45.58	$73.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.43 / $24.89 / $33.69	Professional		$7.43	$24.89	$33.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.36 / $34.75 / $83.79	Professional		$15.36	$34.75	$83.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.09 / $14.41 / $62.71	Professional	26	$11.09	$14.41	$62.71
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.71 / $5.38 / $20.35	Professional	TC	$3.71	$5.38	$20.35
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $111.68 / $111.68 / $111.68	Professional		$111.68	$111.68	$111.68
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $84.37 / $84.37 / $84.37	Professional	26	$84.37	$84.37	$84.37
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $27.31 / $27.31 / $27.31	Professional	TC	$27.31	$27.31	$27.31
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $29.14 / $40.07	Professional		$29.14	$29.14	$40.07
United Facility/Professional Professional Modifier Low / Median / High Price $18.14 / $18.98 / $66.62	Professional		$18.14	$18.98	$66.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $14.33 / $50.82	Professional	26	$13.25	$14.33	$50.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.32 / $4.99 / $16.87	Professional	TC	$4.32	$4.99	$16.87