Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,080.00 / $5,178.00 / $17,013.00	Facility		$1,080.00	$5,178.00	$17,013.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.90 / $137.07 / $730.72	Facility	26	$132.90	$137.07	$730.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.50 / $409.45 / $1,329.48	Professional		$327.50	$409.45	$1,329.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.12 / $146.19 / $550.26	Professional	26	$122.12	$146.19	$550.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $205.37 / $249.37 / $576.65	Professional	TC	$205.37	$249.37	$576.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,137.00 / $5,863.00 / $11,456.00	Facility		$2,137.00	$5,863.00	$11,456.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.30 / $501.74 / $1,113.68	Professional		$331.30	$501.74	$1,113.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $129.11 / $191.54 / $364.57	Professional	26	$129.11	$191.54	$364.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $200.90 / $316.18 / $757.80	Professional	TC	$200.90	$316.18	$757.80
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $5,117.38	Facility		$66.00	$100.00	$5,117.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $226.82 / $370.90 / $904.48	Professional		$226.82	$370.90	$904.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $98.62 / $136.88 / $337.09	Professional	26	$98.62	$136.88	$337.09
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $137.69 / $228.92 / $569.69	Professional	TC	$137.69	$228.92	$569.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.05 / $338.06 / $796.43	Facility		$286.05	$338.06	$796.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.87 / $506.62 / $1,383.67	Professional		$347.87	$506.62	$1,383.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.04 / $167.72 / $483.49	Professional	26	$128.04	$167.72	$483.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.48 / $339.56 / $880.91	Professional	TC	$218.48	$339.56	$880.91
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $224.87 / $337.31 / $548.69	Professional		$224.87	$337.31	$548.69
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.20 / $135.51 / $162.61	Professional	26	$92.20	$135.51	$162.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.19 / $317.47 / $386.08	Professional	TC	$159.19	$317.47	$386.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.99 / $493.85 / $876.00	Professional		$371.99	$493.85	$876.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $121.96 / $169.98 / $311.67	Professional	26	$121.96	$169.98	$311.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $262.29 / $384.45 / $739.98	Professional	TC	$262.29	$384.45	$739.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,043.98 / $1,891.36	Facility		$55.00	$1,043.98	$1,891.36
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $289.62 / $564.64 / $603.96	Facility	26	$289.62	$564.64	$603.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,582.80 / $2,844.40 / $3,019.05	Professional		$2,582.80	$2,844.40	$3,019.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $908.96 / $930.32 / $1,026.90	Professional	26	$908.96	$930.32	$1,026.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,745.64 / $1,914.08 / $1,992.15	Professional	TC	$1,745.64	$1,914.08	$1,992.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $370.30 / $479.26 / $704.96	Facility		$370.30	$479.26	$704.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $348.40 / $529.13 / $1,122.60	Professional		$348.40	$529.13	$1,122.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $128.51 / $165.93 / $394.34	Professional	26	$128.51	$165.93	$394.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $218.48 / $339.56 / $804.68	Professional	TC	$218.48	$339.56	$804.68
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,255.09 / $1,255.09 / $1,255.09	Professional		$1,255.09	$1,255.09	$1,255.09
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $413.50 / $413.50 / $413.50	Professional	26	$413.50	$413.50	$413.50
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $841.59 / $841.59 / $841.59	Professional	TC	$841.59	$841.59	$841.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $224.87 / $382.28 / $508.28	Professional		$224.87	$382.28	$508.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,371.00 / $2,731.00 / $7,940.00	Facility		$1,371.00	$2,731.00	$7,940.00
United Facility/Professional Professional Modifier Low / Median / High Price $298.76 / $440.61 / $1,249.52	Professional		$298.76	$440.61	$1,249.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.48 / $160.60 / $447.02	Professional	26	$102.48	$160.60	$447.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.66 / $272.74 / $782.41	Professional	TC	$193.66	$272.74	$782.41