Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $90.45 / $241.11	Professional		$79.40	$90.45	$241.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.20 / $95.11 / $700.84	Professional	26	$52.20	$95.11	$700.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.42 / $34.11 / $76.79	Professional	TC	$28.42	$34.11	$76.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $306.00 / $306.00 / $306.00	Professional		$306.00	$306.00	$306.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $66.52 / $136.06	Professional	26	$29.54	$66.52	$136.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.85 / $111.96 / $247.13	Professional		$87.85	$111.96	$247.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.24 / $77.27 / $164.14	Professional	26	$57.24	$77.27	$164.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $35.32 / $90.73	Professional	TC	$24.41	$35.32	$90.73
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $103.18 / $251.52	Professional		$75.23	$103.18	$251.52
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $53.10 / $75.18 / $182.44	Professional	26	$53.10	$75.18	$182.44
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $28.00 / $79.11	Professional	TC	$21.65	$28.00	$79.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.91 / $93.91 / $93.91	Facility		$93.91	$93.91	$93.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $60.06 / $192.82	Professional		$47.54	$60.06	$192.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.55 / $38.28 / $124.97	Professional	26	$30.55	$38.28	$124.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $22.55 / $81.31	Professional	TC	$15.33	$22.55	$81.31
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $124.93 / $168.66	Professional		$44.52	$124.93	$168.66
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $69.25 / $93.49	Professional	26	$35.61	$69.25	$93.49
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $8.90 / $55.68 / $75.17	Professional	TC	$8.90	$55.68	$75.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $96.89 / $119.07 / $193.64	Professional		$96.89	$119.07	$193.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.40 / $83.10 / $103.89	Professional	26	$55.40	$83.10	$103.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.14 / $66.59 / $83.52	Professional	TC	$41.14	$66.59	$83.52
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $226.48 / $457.19 / $523.92	Facility		$226.48	$457.19	$523.92
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $141.75 / $272.47 / $300.87	Facility	26	$141.75	$272.47	$300.87
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $88.20 / $184.67 / $223.06	Facility	TC	$88.20	$184.67	$223.06
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $643.49 / $643.49 / $828.68	Professional		$643.49	$643.49	$828.68
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $383.71 / $383.71 / $482.40	Professional	26	$383.71	$383.71	$482.40
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $350.03 / $350.03 / $350.03	Professional	TC	$350.03	$350.03	$350.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.89 / $128.40 / $172.24	Facility		$92.89	$128.40	$172.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.83 / $108.49 / $271.19	Professional		$47.83	$108.49	$271.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.62 / $39.31 / $160.34	Professional	26	$30.62	$39.31	$160.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $23.57 / $87.65	Professional	TC	$15.19	$23.57	$87.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $370.94 / $370.94 / $370.94	Professional		$370.94	$370.94	$370.94
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $239.11 / $239.11 / $239.11	Professional	26	$239.11	$239.11	$239.11
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $131.82 / $131.82 / $131.82	Professional	TC	$131.82	$131.82	$131.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $101.04 / $138.93	Professional		$101.04	$101.04	$138.93
United Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Facility		$126.00	$126.00	$126.00
United Facility/Professional Professional Modifier Low / Median / High Price $53.76 / $62.91 / $220.72	Professional		$53.76	$62.91	$220.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.34 / $41.54 / $163.30	Professional	26	$35.34	$41.54	$163.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $22.59 / $118.48	Professional	TC	$17.48	$22.59	$118.48