Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $41.01 / $156.29	Professional		$34.84	$41.01	$156.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $31.66 / $269.33	Professional	26	$23.90	$31.66	$269.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.88 / $11.71 / $46.85	Professional	TC	$9.88	$11.71	$46.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.50 / $161.50 / $161.50	Professional		$161.50	$161.50	$161.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.37 / $39.14 / $68.54	Professional	26	$14.37	$39.14	$68.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.46 / $53.80 / $117.13	Professional		$38.46	$53.80	$117.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $39.45 / $81.34	Professional	26	$28.18	$39.45	$81.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.99 / $13.98 / $44.06	Professional	TC	$9.99	$13.98	$44.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $34.27 / $47.33 / $115.38	Professional		$34.27	$47.33	$115.38
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $37.15 / $100.00	Professional	26	$26.47	$37.15	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $7.81 / $10.18 / $28.70	Professional	TC	$7.81	$10.18	$28.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.61 / $57.61 / $57.61	Facility		$57.61	$57.61	$57.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $32.63 / $101.72	Professional		$21.26	$32.63	$101.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $18.89 / $61.23	Professional	26	$14.98	$18.89	$61.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.95 / $12.57 / $44.27	Professional	TC	$5.95	$12.57	$44.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $68.33 / $92.25	Professional		$19.39	$68.33	$92.25
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.51 / $34.22 / $46.20	Professional	26	$15.51	$34.22	$46.20
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.88 / $34.11 / $46.05	Professional	TC	$3.88	$34.11	$46.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $64.79 / $105.19	Professional		$52.75	$64.79	$105.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.38 / $41.06 / $51.35	Professional	26	$27.38	$41.06	$51.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.21 / $40.83 / $51.17	Professional	TC	$25.21	$40.83	$51.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $122.57 / $248.27 / $285.52	Facility		$122.57	$248.27	$285.52
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.13 / $134.74 / $148.72	Facility	26	$70.13	$134.74	$148.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $342.09 / $342.09 / $451.80	Professional		$342.09	$342.09	$451.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $250.96 / $250.96 / $250.96	Professional	26	$250.96	$250.96	$250.96
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $250.96 / $250.96 / $250.96	Professional	TC	$250.96	$250.96	$250.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.02 / $68.15 / $92.20	Facility		$44.02	$68.15	$92.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.04 / $52.08 / $147.15	Professional		$22.04	$52.08	$147.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.04 / $19.41 / $79.65	Professional	26	$15.04	$19.41	$79.65
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $5.95 / $12.85 / $45.15	Professional	TC	$5.95	$12.85	$45.15
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $205.66 / $205.66 / $205.66	Professional		$205.66	$205.66	$205.66
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $118.90 / $118.90 / $118.90	Professional	26	$118.90	$118.90	$118.90
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $86.76 / $86.76 / $86.76	Professional	TC	$86.76	$86.76	$86.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $55.26 / $55.26 / $75.98	Professional		$55.26	$55.26	$75.98
United Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $42.00 / $42.00	Facility		$42.00	$42.00	$42.00
United Facility/Professional Professional Modifier Low / Median / High Price $24.11 / $33.35 / $115.91	Professional		$24.11	$33.35	$115.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $21.08 / $87.90	Professional	26	$17.57	$21.08	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.19 / $13.86 / $66.28	Professional	TC	$6.19	$13.86	$66.28