Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $53.21 / $92.68	Professional		$44.27	$53.21	$92.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.15 / $15.69	Professional	26	$7.24	$9.15	$15.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.54 / $44.39 / $79.12	Professional	TC	$36.54	$44.39	$79.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $37.07 / $52.55	Professional		$37.07	$37.07	$52.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.24 / $48.83 / $122.34	Professional		$40.24	$48.83	$122.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $10.48 / $29.72	Professional	26	$8.00	$10.48	$29.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.46 / $37.86 / $117.61	Professional	TC	$27.46	$37.86	$117.61
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $38.83 / $88.56	Professional		$27.18	$38.83	$88.56
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $5.71 / $8.16 / $15.66	Professional	26	$5.71	$8.16	$15.66
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.47 / $30.67 / $75.05	Professional	TC	$21.47	$30.67	$75.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $63.56 / $160.63	Professional		$41.82	$63.56	$160.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $10.91 / $25.40	Professional	26	$7.97	$10.91	$25.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $52.05 / $135.19	Professional	TC	$33.03	$52.05	$135.19
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $21.30 / $86.84	Professional		$16.12	$21.30	$86.84
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $12.93 / $19.39	Professional	26	$9.80	$12.93	$19.39
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.71 / $4.90 / $75.08	Professional	TC	$3.71	$4.90	$75.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.88 / $72.37 / $130.27	Professional		$45.88	$72.37	$130.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $11.52 / $20.38	Professional	26	$8.59	$11.52	$20.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.26 / $68.83 / $120.19	Professional	TC	$48.26	$68.83	$120.19
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.12 / $59.20 / $100.00	Facility	26	$20.12	$59.20	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $343.33 / $343.33 / $459.30	Professional		$343.33	$343.33	$459.30
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.76 / $166.76 / $166.76	Professional	26	$166.76	$166.76	$166.76
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.04 / $288.04 / $388.73	Professional	TC	$288.04	$288.04	$388.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $65.23 / $151.68	Professional		$41.82	$65.23	$151.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $10.79 / $24.58	Professional	26	$7.97	$10.79	$24.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $51.57 / $129.03	Professional	TC	$33.36	$51.57	$129.03
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $177.15 / $177.15 / $177.15	Professional		$177.15	$177.15	$177.15
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $29.84 / $29.84 / $29.84	Professional	26	$29.84	$29.84	$29.84
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $147.30 / $147.30 / $147.30	Professional	TC	$147.30	$147.30	$147.30
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $80.48 / $80.48	Professional		$65.84	$80.48	$80.48
United Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $47.68 / $99.96	Professional		$33.90	$47.68	$99.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $8.34 / $20.42	Professional	26	$6.64	$8.34	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.45 / $39.68 / $75.11	Professional	TC	$27.45	$39.68	$75.11