Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $346.74	Professional		$69.18	$97.72	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $398.11	Professional	26	$51.29	$66.07	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $109.65	Professional	TC	$23.99	$37.15	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $114.82 / $134.90	Professional	26	$56.23	$114.82	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $281.84	Professional		$89.13	$117.49	$281.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $199.53	Professional	26	$58.88	$85.11	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $85.11	Professional	TC	$22.91	$36.31	$85.11
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $102.33 / $229.09	Professional		$77.62	$102.33	$229.09
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $75.86 / $173.78	Professional	26	$58.88	$75.86	$173.78
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.92 / $64.57	Professional	TC	$20.42	$26.92	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $58.88 / $177.83	Professional		$46.77	$58.88	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.02 / $114.82	Professional	26	$30.90	$38.02	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $23.44 / $66.07	Professional	TC	$13.80	$23.44	$66.07
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $151.36	Professional		$79.43	$112.20	$151.36
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $67.61 / $91.20	Professional	26	$50.12	$67.61	$91.20
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $42.66 / $57.54	Professional	TC	$29.51	$42.66	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $169.82	Professional		$89.13	$107.15	$169.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $102.33	Professional	26	$54.95	$77.62	$102.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $46.77 / $64.57	Professional	TC	$32.36	$46.77	$64.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $380.19 / $380.19 / $380.19	Facility	26	$380.19	$380.19	$380.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $741.31	Professional		$588.84	$741.31	$741.31
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $478.63 / $478.63	Professional	26	$380.19	$478.63	$478.63
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $269.15 / $269.15	Professional	TC	$204.17	$269.15	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $93.33 / $251.19	Professional		$47.86	$93.33	$251.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $162.18	Professional	26	$30.90	$46.77	$162.18
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $24.55 / $72.44	Professional	TC	$15.14	$24.55	$72.44
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	26	$239.88	$239.88	$239.88
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	TC	$100.00	$100.00	$100.00
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 $53.70 / $61.66 / $229.09	Professional		$53.70	$61.66	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $40.74 / $154.88	Professional	26	$35.48	$40.74	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.39 / $75.86	Professional	TC	$15.85	$22.39	$75.86