Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $120.81 / $644.41	Professional		$63.95	$120.81	$644.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.81 / $33.06 / $765.75	Professional	26	$21.81	$33.06	$765.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.25 / $46.17 / $441.61	Professional	TC	$32.25	$46.17	$441.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.93 / $53.93 / $53.93	Professional		$53.93	$53.93	$53.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $47.10 / $140.00	Professional	26	$13.36	$47.10	$140.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.13 / $113.95 / $236.00	Professional	TC	$40.13	$113.95	$236.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.63 / $155.94 / $278.08	Professional		$99.63	$155.94	$278.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $56.89 / $98.57	Professional	26	$31.37	$56.89	$98.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.26 / $98.90 / $191.12	Professional	TC	$68.26	$98.90	$191.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.84 / $82.27 / $199.04	Professional		$60.84	$82.27	$199.04
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $13.05 / $38.01	Professional	26	$9.65	$13.05	$38.01
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $51.18 / $69.22 / $167.47	Professional	TC	$51.18	$69.22	$167.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.46 / $58.35 / $195.01	Professional		$38.46	$58.35	$195.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $17.22 / $54.41	Professional	26	$14.50	$17.22	$54.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.62 / $43.21 / $126.64	Professional	TC	$23.62	$43.21	$126.64
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $64.66 / $144.97 / $195.72	Professional		$64.66	$144.97	$195.72
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.57 / $31.92 / $43.09	Professional	26	$24.57	$31.92	$43.09
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.09 / $113.06 / $152.63	Professional	TC	$40.09	$113.06	$152.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.15 / $134.90 / $218.07	Professional		$112.15	$134.90	$218.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.54 / $38.29 / $47.90	Professional	26	$25.54	$38.29	$47.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $83.51 / $135.08 / $169.59	Professional	TC	$83.51	$135.08	$169.59
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $68.33 / $127.16 / $139.56	Facility	26	$68.33	$127.16	$139.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $750.04 / $750.04 / $924.23	Professional		$750.04	$750.04	$924.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $179.95 / $179.95 / $224.33	Professional	26	$179.95	$179.95	$224.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $570.15 / $570.15 / $699.90	Professional	TC	$570.15	$570.15	$699.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.27 / $80.48 / $129.85	Professional		$33.27	$80.48	$129.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $99.45 / $302.16	Professional		$39.40	$99.45	$302.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $18.10 / $59.85	Professional	26	$14.65	$18.10	$59.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $47.77 / $126.64	Professional	TC	$23.82	$47.77	$126.64
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $351.78 / $351.78 / $351.78	Professional		$351.78	$351.78	$351.78
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $110.71 / $110.71 / $110.71	Professional	26	$110.71	$110.71	$110.71
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $241.07 / $241.07 / $241.07	Professional	TC	$241.07	$241.07	$241.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $117.27 / $117.27 / $161.25	Professional		$117.27	$117.27	$161.25
United Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $60.34 / $200.20	Professional		$44.35	$60.34	$200.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $18.20 / $66.70	Professional	26	$17.18	$18.20	$66.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.48 / $42.82 / $148.93	Professional	TC	$26.48	$42.82	$148.93