Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.63 / $68.89 / $117.59	Professional		$40.63	$68.89	$117.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $20.95 / $47.69	Professional	26	$17.36	$20.95	$47.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $44.99 / $71.09	Professional	TC	$22.16	$44.99	$71.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $43.72 / $122.37	Professional		$38.84	$43.72	$122.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.56 / $67.95 / $154.72	Professional		$47.56	$67.95	$154.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $24.91 / $75.62	Professional	26	$20.07	$24.91	$75.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $43.11 / $97.26	Professional	TC	$22.01	$43.11	$97.26
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $42.54 / $60.77 / $83.23	Professional		$42.54	$60.77	$83.23
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $20.89 / $28.13	Professional	26	$14.62	$20.89	$28.13
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $27.92 / $39.89 / $57.24	Professional	TC	$27.92	$39.89	$57.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $75.38 / $201.87	Professional		$43.38	$75.38	$201.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $27.66 / $87.23	Professional	26	$18.88	$27.66	$87.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $47.75 / $122.12	Professional	TC	$24.01	$47.75	$122.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $51.11 / $65.29	Professional		$32.71	$51.11	$65.29
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $26.23 / $39.92	Professional	26	$23.40	$26.23	$39.92
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.52 / $11.76 / $39.54	Professional	TC	$7.52	$11.76	$39.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.32 / $51.78 / $90.62	Professional		$43.32	$51.78	$90.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.94 / $21.06 / $29.25	Professional	26	$18.94	$21.06	$29.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.42 / $32.36 / $43.86	Professional	TC	$26.42	$32.36	$43.86
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.60 / $63.43 / $101.79	Facility	26	$47.60	$63.43	$101.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $339.23 / $349.41 / $388.58	Professional		$339.23	$349.41	$388.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.44 / $128.44 / $163.95	Professional	26	$128.44	$128.44	$163.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $221.35 / $227.99 / $227.99	Professional	TC	$221.35	$227.99	$227.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $74.80 / $156.26	Professional		$43.62	$74.80	$156.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.43 / $27.37 / $64.12	Professional	26	$18.43	$27.37	$64.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $47.75 / $109.27	Professional	TC	$23.40	$47.75	$109.27
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $157.97 / $157.97 / $157.97	Professional		$157.97	$157.97	$157.97
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $70.76 / $70.76 / $70.76	Professional	26	$70.76	$70.76	$70.76
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $87.20 / $87.20 / $87.20	Professional	TC	$87.20	$87.20	$87.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $65.98 / $65.98	Professional		$53.99	$65.98	$65.98
United Facility/Professional Professional Modifier Low / Median / High Price $36.18 / $49.38 / $120.17	Professional		$36.18	$49.38	$120.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $20.13 / $52.51	Professional	26	$15.86	$20.13	$52.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.97 / $28.49 / $73.77	Professional	TC	$19.97	$28.49	$73.77