Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $66.07	Professional		$21.88	$30.20	$66.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.89 / $33.88	Professional	26	$18.20	$20.89	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $28.84	Professional	TC	$3.02	$3.98	$28.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.99 / $31.62	Professional		$19.95	$23.99	$31.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $64.57 / $125.89	Professional		$29.51	$64.57	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.88 / $83.18	Professional	26	$20.42	$33.88	$83.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.13 / $30.90 / $67.61	Professional	TC	$5.13	$30.90	$67.61
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $66.07 / $97.72	Professional		$52.48	$66.07	$97.72
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.30 / $39.81	Professional	26	$20.89	$26.30	$39.81
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $39.81 / $57.54	Professional	TC	$27.54	$39.81	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $23.44 / $33.88	Facility	26	$5.01	$23.44	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $41.69 / $91.20	Professional		$21.88	$41.69	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $24.55 / $58.88	Professional	26	$17.38	$24.55	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.74 / $7.94 / $44.67	Professional	TC	$1.74	$7.94	$44.67
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $18.62 / $33.11	Professional		$14.13	$18.62	$33.11
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $7.41 / $26.92	Professional	26	$5.62	$7.41	$26.92
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.75 / $8.71 / $13.18	Professional	TC	$5.75	$8.71	$13.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.92 / $47.86	Professional		$21.88	$26.92	$47.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.88 / $26.30	Professional	26	$19.05	$21.88	$26.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $5.25 / $5.75	Professional	TC	$4.07	$5.25	$5.75
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $323.59	Professional		$302.00	$302.00	$323.59
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $165.96 / $165.96	Professional	26	$158.49	$165.96	$165.96
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $223.87	Professional	TC	$186.21	$186.21	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $29.51 / $35.48	Professional		$5.89	$29.51	$35.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $42.66 / $85.11	Professional		$21.38	$42.66	$85.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $24.55 / $54.95	Professional	26	$17.38	$24.55	$54.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1.70 / $7.76 / $44.67	Professional	TC	$1.70	$7.76	$44.67
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	26	$69.18	$69.18	$69.18
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $13.80 / $13.80	Professional	TC	$13.80	$13.80	$13.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $33.88	Professional		$27.54	$27.54	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.51 / $66.07	Professional		$19.05	$29.51	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.95 / $38.02	Professional	26	$15.85	$19.95	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $5.13 / $35.48	Professional	TC	$3.02	$5.13	$35.48