Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $91.66 / $254.81	Professional		$69.41	$91.66	$254.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.35 / $63.22 / $230.04	Professional	26	$48.35	$63.22	$230.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.32 / $36.35 / $89.40	Professional	TC	$23.32	$36.35	$89.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.71 / $183.71 / $183.71	Professional		$183.71	$183.71	$183.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.90 / $114.50 / $191.25	Professional	26	$28.90	$114.50	$191.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.36 / $115.21 / $233.21	Professional		$89.36	$115.21	$233.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.60 / $77.76 / $164.03	Professional	26	$57.60	$77.76	$164.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $37.85 / $79.66	Professional	TC	$22.87	$37.85	$79.66
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $92.51 / $225.51	Professional		$68.94	$92.51	$225.51
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $50.10 / $68.73 / $167.57	Professional	26	$50.10	$68.73	$167.57
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $23.77 / $67.23	Professional	TC	$18.84	$23.77	$67.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.94 / $58.26 / $194.94	Professional		$45.94	$58.26	$194.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.94 / $38.22 / $125.64	Professional	26	$30.94	$38.22	$125.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.97 / $23.39 / $69.30	Professional	TC	$14.97	$23.39	$69.30
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $79.42 / $111.51 / $150.54	Professional		$79.42	$111.51	$150.54
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.03 / $68.68 / $92.72	Professional	26	$50.03	$68.68	$92.72
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.39 / $42.83 / $57.82	Professional	TC	$29.39	$42.83	$57.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.15 / $107.25 / $172.84	Professional		$89.15	$107.25	$172.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.94 / $82.42 / $103.05	Professional	26	$54.94	$82.42	$103.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.65 / $51.24 / $64.25	Professional	TC	$31.65	$51.24	$64.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $145.58 / $270.97 / $298.82	Facility	26	$145.58	$270.97	$298.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $587.10 / $587.10 / $746.40	Professional		$587.10	$587.10	$746.40
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $381.48 / $381.48 / $479.33	Professional	26	$381.48	$381.48	$479.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.55 / $205.55 / $267.08	Professional	TC	$205.55	$205.55	$267.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.44 / $71.02 / $106.34	Professional		$29.44	$71.02	$106.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.96 / $108.18 / $248.50	Professional		$47.96	$108.18	$248.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.94 / $39.96 / $162.47	Professional	26	$30.94	$39.96	$162.47
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.12 / $23.93 / $70.33	Professional	TC	$15.12	$23.93	$70.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $339.48 / $339.48 / $339.48	Professional		$339.48	$339.48	$339.48
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $239.06 / $239.06 / $239.06	Professional	26	$239.06	$239.06	$239.06
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $100.41 / $100.41 / $100.41	Professional	TC	$100.41	$100.41	$100.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $90.18 / $90.18 / $124.00	Professional		$90.18	$90.18	$124.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.73 / $59.72 / $202.95	Professional		$54.73	$59.72	$202.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $40.25 / $144.84	Professional	26	$35.95	$40.25	$144.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $22.26 / $90.39	Professional	TC	$16.03	$22.26	$90.39