Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.27 / $54.29 / $79.09	Professional		$38.27	$54.29	$79.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.65 / $18.55 / $60.47	Professional	26	$13.65	$18.55	$60.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.62 / $35.22 / $52.87	Professional	TC	$24.62	$35.22	$52.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $103.44 / $208.13	Professional		$79.27	$103.44	$208.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $33.17 / $66.94	Professional	26	$25.71	$33.17	$66.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.59 / $70.26 / $141.38	Professional	TC	$50.59	$70.26	$141.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $68.45 / $158.22	Professional		$50.53	$68.45	$158.22
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $4.62 / $6.17 / $10.36	Professional	26	$4.62	$6.17	$10.36
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $42.97 / $57.84 / $93.17	Professional	TC	$42.97	$57.84	$93.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.14 / $45.99 / $144.16	Professional		$32.14	$45.99	$144.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.92 / $14.91 / $47.75	Professional	26	$10.92	$14.91	$47.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $31.30 / $97.08	Professional	TC	$21.22	$31.30	$97.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $83.90 / $113.27	Professional		$54.01	$83.90	$113.27
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $27.30 / $36.86	Professional	26	$17.82	$27.30	$36.86
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.19 / $56.60 / $76.41	Professional	TC	$36.19	$56.60	$76.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $78.48 / $127.87	Professional		$65.76	$78.48	$127.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $32.76 / $40.95	Professional	26	$21.84	$32.76	$40.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.82 / $67.69 / $84.90	Professional	TC	$41.82	$67.69	$84.90
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.10 / $110.49 / $120.37	Facility	26	$60.10	$110.49	$120.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $438.19 / $438.19 / $544.20	Professional		$438.19	$438.19	$544.20
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.25 / $158.25 / $192.30	Professional	26	$158.25	$158.25	$192.30
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $279.94 / $279.94 / $351.98	Professional	TC	$279.94	$279.94	$351.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $40.04 / $64.28	Professional		$24.24	$40.04	$64.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $80.14 / $192.85	Professional		$34.04	$80.14	$192.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $16.39 / $49.20	Professional	26	$11.32	$16.39	$49.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $34.82 / $104.46	Professional	TC	$21.77	$34.82	$104.46
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $280.08 / $280.08 / $280.08	Professional		$280.08	$280.08	$280.08
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $101.21 / $101.21 / $101.21	Professional	26	$101.21	$101.21	$101.21
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $178.88 / $178.88 / $178.88	Professional	TC	$178.88	$178.88	$178.88
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.86 / $67.86 / $93.31	Professional		$67.86	$67.86	$93.31
United Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $48.44 / $212.48	Professional		$37.39	$48.44	$212.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.06 / $17.28 / $69.76	Professional	26	$13.06	$17.28	$69.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $30.68 / $110.47	Professional	TC	$24.33	$30.68	$110.47