Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $446.68	Professional		$89.13	$125.89	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $45.71 / $213.80	Professional	26	$25.70	$45.71	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $81.28 / $812.83	Professional	TC	$53.70	$81.28	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $309.03	Professional		$141.25	$141.25	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $190.55	Professional	26	$57.54	$57.54	$190.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	TC	$151.36	$151.36	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $371.54	Professional		$56.23	$112.20	$371.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $54.95 / $120.23	Professional	26	$40.74	$54.95	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $61.66 / $239.88	Professional	TC	$12.88	$61.66	$239.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.23 / $269.15	Professional		$91.20	$120.23	$269.15
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $134.90	Professional	26	$45.71	$58.88	$134.90
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $138.04	Professional	TC	$47.86	$61.66	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $269.15	Professional		$51.29	$77.62	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.44 / $83.18	Professional	26	$19.05	$23.44	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $53.70 / $169.82	Professional	TC	$29.51	$53.70	$169.82
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $186.21 / $251.19	Professional		$56.23	$186.21	$251.19
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $44.67 / $52.48	Professional	26	$38.90	$44.67	$52.48
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $144.54 / $194.98	Professional	TC	$11.22	$144.54	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $275.42	Professional		$141.25	$173.78	$275.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $45.71 / $58.88	Professional	26	$31.62	$45.71	$58.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $158.49 / $218.78	Professional	TC	$109.65	$158.49	$218.78
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,202.26 / $1,202.26	Professional		$977.24	$1,202.26	$1,202.26
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $275.42 / $275.42	Professional	26	$239.88	$275.42	$275.42
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $933.25 / $933.25	Professional	TC	$758.58	$933.25	$933.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $100.00 / $331.13	Professional		$52.48	$100.00	$331.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.18 / $97.72	Professional	26	$19.50	$28.18	$97.72
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $60.26 / $186.21	Professional	TC	$30.90	$60.26	$186.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	26	$138.04	$138.04	$138.04
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $346.74 / $346.74	Professional	TC	$346.74	$346.74	$346.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $208.93	Professional		$151.36	$151.36	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $89.13 / $331.13	Professional		$57.54	$89.13	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $25.70 / $91.20	Professional	26	$22.39	$25.70	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $61.66 / $263.03	Professional	TC	$34.67	$61.66	$263.03