Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.52 / $226.03 / $534.28	Professional		$104.52	$226.03	$534.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.63 / $51.39 / $205.70	Professional	26	$29.63	$51.39	$205.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.55 / $174.65 / $474.17	Professional	TC	$65.55	$174.65	$474.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.66 / $305.64 / $567.04	Professional		$131.66	$305.64	$567.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.46 / $89.62 / $152.63	Professional	26	$38.46	$89.62	$152.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.20 / $216.18 / $406.52	Professional	TC	$93.20	$216.18	$406.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $174.03 / $249.61 / $588.29	Professional		$174.03	$249.61	$588.29
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.05 / $64.01 / $152.65	Professional	26	$45.05	$64.01	$152.65
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $129.93 / $185.61 / $446.07	Professional	TC	$129.93	$185.61	$446.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $131.13 / $394.67	Professional		$57.00	$131.13	$394.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $33.01 / $98.43	Professional	26	$17.48	$33.01	$98.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $96.24 / $286.87	Professional	TC	$38.54	$96.24	$286.87
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $96.07 / $141.33 / $190.80	Professional		$96.07	$141.33	$190.80
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.93 / $48.51 / $76.86	Professional	26	$35.93	$48.51	$76.86
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $105.40 / $142.29	Professional	TC	$19.21	$105.40	$142.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $131.80 / $213.87	Professional		$109.99	$131.80	$213.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.74 / $43.12 / $53.91	Professional	26	$28.74	$43.12	$53.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.87 / $126.05 / $158.10	Professional	TC	$77.87	$126.05	$158.10
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $77.94 / $256.47 / $256.47	Facility	26	$77.94	$256.47	$256.47
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,150.51 / $1,210.67 / $1,210.67	Professional		$1,150.51	$1,210.67	$1,210.67
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $360.79 / $361.60 / $361.60	Professional	26	$360.79	$361.60	$361.60
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $788.91 / $914.18 / $914.18	Professional	TC	$788.91	$914.18	$914.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $74.06 / $106.23	Professional		$32.15	$74.06	$106.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.69 / $209.16 / $341.13	Professional		$60.69	$209.16	$341.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.36 / $34.90 / $98.43	Professional	26	$18.36	$34.90	$98.43
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $38.25 / $107.13 / $286.87	Professional	TC	$38.25	$107.13	$286.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $430.18 / $430.18 / $430.18	Professional		$430.18	$430.18	$430.18
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $130.38 / $130.38 / $130.38	Professional	26	$130.38	$130.38	$130.38
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $299.79 / $299.79 / $299.79	Professional	TC	$299.79	$299.79	$299.79
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $114.31 / $114.31 / $157.18	Professional		$114.31	$114.31	$157.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.08 / $122.21 / $345.12	Professional		$69.08	$122.21	$345.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.44 / $35.72 / $89.57	Professional	26	$21.44	$35.72	$89.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.64 / $88.89 / $255.07	Professional	TC	$47.64	$88.89	$255.07