Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.66 / $133.72 / $547.80	Professional		$89.66	$133.72	$547.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.18 / $84.18 / $528.55	Professional	26	$42.18	$84.18	$528.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.21 / $83.62 / $366.15	Professional	TC	$50.21	$83.62	$366.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.69 / $64.88 / $340.00	Professional		$57.69	$64.88	$340.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $67.31 / $200.14	Professional	26	$19.68	$67.31	$200.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.47 / $146.47 / $435.39	Professional	TC	$146.47	$146.47	$435.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.83 / $162.16 / $353.45	Professional		$115.83	$162.16	$353.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.61 / $79.58 / $152.78	Professional	26	$45.61	$79.58	$152.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.74 / $84.03 / $205.72	Professional	TC	$63.74	$84.03	$205.72
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $129.13 / $314.77	Professional		$96.12	$129.13	$314.77
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $70.31 / $169.70	Professional	26	$49.65	$70.31	$169.70
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $46.21 / $58.82 / $141.34	Professional	TC	$46.21	$58.82	$141.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.74 / $182.74 / $182.74	Facility		$182.74	$182.74	$182.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $81.06 / $271.22	Professional		$60.56	$81.06	$271.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $30.04 / $107.48	Professional	26	$21.84	$30.04	$107.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $50.33 / $171.91	Professional	TC	$34.15	$50.33	$171.91
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $56.74 / $154.13 / $208.08	Professional		$56.74	$154.13	$208.08
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.39 / $45.66 / $61.64	Professional	26	$45.39	$45.66	$61.64
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.35 / $108.47 / $146.43	Professional	TC	$11.35	$108.47	$146.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.03 / $145.91 / $233.40	Professional		$120.03	$145.91	$233.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.53 / $54.79 / $68.51	Professional	26	$36.53	$54.79	$68.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $80.12 / $129.61 / $162.71	Professional	TC	$80.12	$129.61	$162.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $264.01 / $540.45 / $633.51	Facility		$264.01	$540.45	$633.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.98 / $221.64 / $221.64	Facility	26	$95.98	$221.64	$221.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $764.45 / $764.45 / $991.43	Professional		$764.45	$764.45	$991.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $310.87 / $311.07 / $319.80	Professional	26	$310.87	$311.07	$319.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $507.20 / $507.20 / $671.63	Professional	TC	$507.20	$507.20	$671.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.88 / $84.84 / $132.72	Professional		$47.88	$84.84	$132.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.30 / $158.66 / $246.61	Facility		$114.30	$158.66	$246.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.98 / $142.38 / $336.30	Professional		$61.98	$142.38	$336.30
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.83 / $35.10 / $125.29	Professional	26	$23.83	$35.10	$125.29
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.27 / $54.80 / $181.11	Professional	TC	$33.27	$54.80	$181.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $475.93 / $475.93 / $475.93	Professional		$475.93	$475.93	$475.93
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $161.12 / $161.12 / $161.12	Professional	26	$161.12	$161.12	$161.12
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $314.81 / $314.81 / $314.81	Professional	TC	$314.81	$314.81	$314.81
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $124.67 / $124.67 / $171.42	Professional		$124.67	$124.67	$171.42
United Facility/Professional Professional Modifier Low / Median / High Price $71.56 / $82.69 / $280.27	Professional		$71.56	$82.69	$280.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $33.21 / $110.16	Professional	26	$26.42	$33.21	$110.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.10 / $50.02 / $183.41	Professional	TC	$39.10	$50.02	$183.41