Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.70 / $111.33 / $442.06	Professional		$60.70	$111.33	$442.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.30 / $41.01 / $223.10	Professional	26	$22.30	$41.01	$223.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.36 / $86.84 / $318.42	Professional	TC	$57.36	$86.84	$318.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.64 / $63.12 / $119.33	Professional		$54.64	$63.12	$119.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $45.20 / $89.39	Professional	26	$12.65	$45.20	$89.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.99 / $49.66 / $385.00	Professional	TC	$41.99	$49.66	$385.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $116.43 / $270.61	Professional		$34.29	$116.43	$270.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.89 / $32.51 / $65.81	Professional	26	$24.89	$32.51	$65.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.75 / $85.70 / $201.45	Professional	TC	$5.75	$85.70	$201.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $71.18 / $98.89 / $230.65	Professional		$71.18	$98.89	$230.65
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $23.88 / $68.23	Professional	26	$16.80	$23.88	$68.23
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $54.21 / $75.02 / $171.42	Professional	TC	$54.21	$75.02	$171.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.64 / $198.64 / $198.64	Facility		$198.64	$198.64	$198.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.23 / $64.65 / $213.97	Professional		$49.23	$64.65	$213.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.38 / $16.01 / $53.76	Professional	26	$13.38	$16.01	$53.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $48.29 / $162.52	Professional	TC	$35.04	$48.29	$162.52
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.83 / $147.04 / $198.50	Professional		$32.83	$147.04	$198.50
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.26 / $29.25 / $39.49	Professional	26	$26.26	$29.25	$39.49
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.57 / $117.79 / $159.02	Professional	TC	$6.57	$117.79	$159.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.62 / $136.74 / $220.92	Professional		$113.62	$136.74	$220.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $35.10 / $43.88	Professional	26	$23.40	$35.10	$43.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $140.85 / $176.69	Professional	TC	$87.02	$140.85	$176.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $245.88 / $507.12 / $599.64	Facility		$245.88	$507.12	$599.64
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $116.58 / $127.87	Facility	26	$61.34	$116.58	$127.87
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $186.52 / $390.55 / $471.77	Facility	TC	$186.52	$390.55	$471.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $715.47 / $715.47 / $937.95	Professional		$715.47	$715.47	$937.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.69 / $162.69 / $205.80	Professional	26	$162.69	$162.69	$205.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $552.78 / $552.78 / $732.15	Professional	TC	$552.78	$552.78	$732.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.09 / $126.24 / $193.26	Facility		$39.09	$126.24	$193.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.04 / $119.36 / $298.50	Professional		$50.04	$119.36	$298.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $16.85 / $71.09	Professional	26	$13.50	$16.85	$71.09
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $57.09 / $188.87	Professional	TC	$34.19	$57.09	$188.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $401.22 / $401.22 / $401.22	Professional		$401.22	$401.22	$401.22
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $101.43 / $101.43 / $101.43	Professional	26	$101.43	$101.43	$101.43
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $299.79 / $299.79 / $299.79	Professional	TC	$299.79	$299.79	$299.79
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $118.93 / $118.93 / $163.53	Professional		$118.93	$118.93	$163.53
United Facility/Professional Facility Modifier Low / Median / High Price $35.70 / $35.70 / $35.70	Facility		$35.70	$35.70	$35.70
United Facility/Professional Professional Modifier Low / Median / High Price $54.80 / $64.31 / $362.76	Professional		$54.80	$64.31	$362.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $17.20 / $59.60	Professional	26	$15.52	$17.20	$59.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.64 / $51.24 / $185.19	Professional	TC	$40.64	$51.24	$185.19