Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.07 / $49.38 / $84.33	Professional		$29.07	$49.38	$84.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $15.62 / $24.78	Professional	26	$13.52	$15.62	$24.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.77 / $31.51 / $51.13	Professional	TC	$14.77	$31.51	$51.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.30 / $31.30 / $31.30	Professional		$31.30	$31.30	$31.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $18.04 / $18.04	Professional	26	$18.04	$18.04	$18.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $20.02 / $20.02	Professional	TC	$20.02	$20.02	$20.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.93 / $50.74 / $115.52	Professional		$32.93	$50.74	$115.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.20 / $19.38 / $59.92	Professional	26	$15.20	$19.38	$59.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.53 / $30.37 / $70.34	Professional	TC	$16.53	$30.37	$70.34
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $117.88 / $266.33 / $322.58	Facility		$117.88	$266.33	$322.58
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $46.60 / $63.55	Professional		$32.61	$46.60	$63.55
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $16.61 / $22.35	Professional	26	$11.63	$16.61	$22.35
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $29.98 / $43.37	Professional	TC	$20.99	$29.98	$43.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.96 / $58.31 / $158.07	Professional		$30.96	$58.31	$158.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $21.32 / $65.86	Professional	26	$14.67	$21.32	$65.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.10 / $34.90 / $86.17	Professional	TC	$16.10	$34.90	$86.17
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $42.06 / $50.47	Professional		$31.63	$42.06	$50.47
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $25.37 / $38.61	Professional	26	$18.05	$25.37	$38.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.27 / $11.37 / $26.41	Professional	TC	$7.27	$11.37	$26.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.82 / $36.82 / $64.44	Professional		$30.82	$36.82	$64.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.58 / $16.25 / $22.56	Professional	26	$14.58	$16.25	$22.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $21.61 / $29.34	Professional	TC	$17.67	$21.61	$29.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $98.62 / $108.08 / $174.90	Facility		$98.62	$108.08	$174.90
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $36.40 / $46.52 / $100.00	Facility	26	$36.40	$46.52	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $277.88 / $354.38 / $366.08	Professional		$277.88	$354.38	$366.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.32 / $98.61 / $126.75	Professional	26	$98.32	$98.61	$126.75
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $180.44 / $180.44 / $180.44	Professional	TC	$180.44	$180.44	$180.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.72 / $42.51 / $74.55	Facility		$28.72	$42.51	$74.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $55.03 / $117.34	Professional		$31.64	$55.03	$117.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $21.00 / $48.31	Professional	26	$14.23	$21.00	$48.31
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.75 / $34.90 / $77.54	Professional	TC	$15.75	$34.90	$77.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $111.58 / $111.58 / $111.58	Professional		$111.58	$111.58	$111.58
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $53.23 / $53.23 / $53.23	Professional	26	$53.23	$53.23	$53.23
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $58.35 / $58.35 / $58.35	Professional	TC	$58.35	$58.35	$58.35
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $46.76 / $46.76	Professional		$38.26	$46.76	$46.76
United Facility/Professional Facility Modifier Low / Median / High Price $44.55 / $44.55 / $44.55	Facility		$44.55	$44.55	$44.55
United Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $36.10 / $84.95	Professional		$25.65	$36.10	$84.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $15.52 / $41.22	Professional	26	$12.42	$15.52	$41.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.23 / $20.10 / $45.42	Professional	TC	$13.23	$20.10	$45.42