Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.19 / $40.54 / $66.00	Professional		$23.19	$40.54	$66.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $21.25 / $32.78	Professional	26	$18.44	$21.25	$32.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.90 / $7.29 / $31.88	Professional	TC	$3.90	$7.29	$31.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $54.04 / $110.79	Professional		$26.40	$54.04	$110.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.03 / $24.37 / $69.91	Professional	26	$20.03	$24.37	$69.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.58 / $30.76 / $62.00	Professional	TC	$4.58	$30.76	$62.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $41.83 / $59.75 / $80.94	Professional		$41.83	$59.75	$80.94
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $23.53 / $31.88	Professional	26	$16.47	$23.53	$31.88
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $25.36 / $36.22 / $48.92	Professional	TC	$25.36	$36.22	$48.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $49.19 / $120.97	Professional		$23.12	$49.19	$120.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.66 / $27.40 / $84.30	Professional	26	$19.66	$27.40	$84.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $10.28 / $52.27	Professional	TC	$1.75	$10.28	$52.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $13.99 / $18.48 / $32.46	Professional		$13.99	$18.48	$32.46
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.59 / $7.39 / $26.25	Professional	26	$5.59	$7.39	$26.25
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.65 / $8.74 / $13.11	Professional	TC	$5.65	$8.74	$13.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.64 / $26.56 / $47.00	Professional		$22.64	$26.56	$47.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.27 / $21.47 / $29.83	Professional	26	$19.27	$21.47	$29.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $4.20 / $5.09 / $6.98	Professional	TC	$4.20	$5.09	$6.98
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.22 / $100.00 / $103.65	Facility	26	$48.22	$100.00	$103.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $303.88 / $313.77 / $322.37	Professional		$303.88	$313.77	$322.37
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $156.85 / $156.85 / $166.80	Professional	26	$156.85	$156.85	$166.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $187.09 / $220.13 / $226.16	Professional	TC	$187.09	$220.13	$226.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.19 / $44.40 / $98.32	Professional		$23.19	$44.40	$98.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.97 / $26.91 / $61.87	Professional	26	$18.97	$26.91	$61.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $9.57 / $52.27	Professional	TC	$1.75	$9.57	$52.27
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $83.43 / $83.43 / $83.43	Professional		$83.43	$83.43	$83.43
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $69.56 / $69.56 / $69.56	Professional	26	$69.56	$69.56	$69.56
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $13.87 / $13.87 / $13.87	Professional	TC	$13.87	$13.87	$13.87
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $26.84 / $32.79 / $32.79	Professional		$26.84	$32.79	$32.79
United Facility/Professional Professional Modifier Low / Median / High Price $19.19 / $29.51 / $69.64	Professional		$19.19	$29.51	$69.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.20 / $20.03 / $57.54	Professional	26	$16.20	$20.03	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.06 / $5.03 / $31.97	Professional	TC	$3.06	$5.03	$31.97