Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $43.84 / $95.26	Professional		$26.59	$43.84	$95.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.12 / $22.73 / $39.08	Professional	26	$16.12	$22.73	$39.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.19 / $15.79 / $34.54	Professional	52	$12.19	$15.79	$34.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.70 / $7.14 / $45.10	Professional	TC	$3.70	$7.14	$45.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.46 / $55.25 / $121.05	Professional		$30.46	$55.25	$121.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.95 / $25.42 / $71.80	Professional	26	$16.95	$25.42	$71.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.34 / $35.29 / $71.65	Professional	TC	$4.34	$35.29	$71.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $42.86 / $61.23 / $82.66	Professional		$42.86	$61.23	$82.66
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.72 / $26.79	Professional	26	$13.80	$19.72	$26.79
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $29.04 / $41.49 / $56.06	Professional	TC	$29.04	$41.49	$56.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.15 / $55.76 / $141.30	Professional		$27.15	$55.76	$141.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $29.33 / $99.19	Professional	26	$18.14	$29.33	$99.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $10.28 / $60.59	Professional	TC	$1.75	$10.28	$60.59
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $13.37 / $17.67 / $37.07	Professional		$13.37	$17.67	$37.07
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.35 / $7.07 / $31.36	Professional	26	$5.35	$7.07	$31.36
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.19 / $8.36 / $12.54	Professional	TC	$5.19	$8.36	$12.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.95 / $30.33 / $53.43	Professional		$25.95	$30.33	$53.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.02 / $25.66 / $35.64	Professional	26	$23.02	$25.66	$35.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.86 / $4.67 / $6.43	Professional	TC	$3.86	$4.67	$6.43
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.67 / $112.04 / $123.79	Facility	26	$57.67	$112.04	$123.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $303.81 / $312.93 / $312.93	Professional		$303.81	$312.93	$312.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $156.38 / $156.38 / $198.75	Professional	26	$156.38	$156.38	$198.75
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $211.93 / $217.43 / $217.43	Professional	TC	$211.93	$217.43	$217.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.87 / $50.83 / $110.27	Professional		$26.87	$50.83	$110.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $29.10 / $72.90	Professional	26	$18.14	$29.10	$72.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $8.71 / $60.59	Professional	TC	$1.75	$8.71	$60.59
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $97.46 / $97.46 / $97.46	Professional		$97.46	$97.46	$97.46
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $83.59 / $83.59 / $83.59	Professional	26	$83.59	$83.59	$83.59
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 $30.65 / $37.47 / $37.47	Professional		$30.65	$37.47	$37.47
United Facility/Professional Professional Modifier Low / Median / High Price $21.84 / $31.88 / $74.05	Professional		$21.84	$31.88	$74.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.08 / $22.08 / $69.13	Professional	26	$15.08	$22.08	$69.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.90 / $4.93 / $35.35	Professional	TC	$2.90	$4.93	$35.35