Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $210.54 / $220.92 / $1,342.56	Facility	26	$210.54	$220.92	$1,342.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $503.30 / $613.49 / $2,393.00	Professional		$503.30	$613.49	$2,393.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $206.00 / $278.35 / $1,064.36	Professional	26	$206.00	$278.35	$1,064.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $292.23 / $351.60 / $1,494.00	Professional	TC	$292.23	$351.60	$1,494.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $402.64 / $462.67 / $1,178.75	Professional		$402.64	$462.67	$1,178.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $215.24 / $436.34 / $611.40	Professional	26	$215.24	$436.34	$611.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $646.16 / $915.93 / $2,163.01	Professional		$646.16	$915.93	$2,163.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $244.52 / $306.24 / $616.17	Professional	26	$244.52	$306.24	$616.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $401.65 / $563.46 / $1,557.01	Professional	TC	$401.65	$563.46	$1,557.01
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $559.13 / $813.60 / $1,825.71	Professional		$559.13	$813.60	$1,825.71
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $201.29 / $287.55 / $700.96	Professional	26	$201.29	$287.55	$700.96
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $357.84 / $511.56 / $1,139.06	Professional	TC	$357.84	$511.56	$1,139.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.43 / $826.12 / $1,948.65	Professional		$438.43	$826.12	$1,948.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $193.25 / $285.75 / $636.28	Professional	26	$193.25	$285.75	$636.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $247.38 / $480.80 / $1,419.12	Professional	TC	$247.38	$480.80	$1,419.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $429.75 / $616.17 / $831.84	Professional		$429.75	$616.17	$831.84
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $184.79 / $261.29 / $352.74	Professional	26	$184.79	$261.29	$352.74
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.96 / $354.89 / $479.10	Professional	TC	$244.96	$354.89	$479.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $471.60 / $619.26 / $1,158.42	Professional		$471.60	$619.26	$1,158.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $224.33 / $322.97 / $539.21	Professional	26	$224.33	$322.97	$539.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $273.85 / $416.50 / $667.19	Professional	TC	$273.85	$416.50	$667.19
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $528.44 / $1,325.34 / $1,325.34	Facility	26	$528.44	$1,325.34	$1,325.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,381.05 / $7,602.48 / $7,602.48	Professional		$7,381.05	$7,602.48	$7,602.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,699.00 / $1,699.00 / $1,841.48	Professional	26	$1,699.00	$1,699.00	$1,841.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $6,233.93 / $6,420.95 / $6,420.95	Professional	TC	$6,233.93	$6,420.95	$6,420.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $449.84 / $868.13 / $1,721.78	Professional		$449.84	$868.13	$1,721.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $197.00 / $285.75 / $611.99	Professional	26	$197.00	$285.75	$611.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $247.38 / $508.64 / $1,350.65	Professional	TC	$247.38	$508.64	$1,350.65
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,625.77 / $1,625.77 / $1,625.77	Professional		$1,625.77	$1,625.77	$1,625.77
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $744.32 / $744.32 / $744.32	Professional	26	$744.32	$744.32	$744.32
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $881.45 / $881.45 / $881.45	Professional	TC	$881.45	$881.45	$881.45
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $498.29 / $685.15 / $1,982.79	Professional		$498.29	$685.15	$1,982.79
United Facility/Professional Professional Modifier Low / Median / High Price $469.20 / $640.16 / $1,632.55	Professional		$469.20	$640.16	$1,632.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $177.27 / $290.52 / $728.39	Professional	26	$177.27	$290.52	$728.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $277.64 / $345.92 / $1,030.20	Professional	TC	$277.64	$345.92	$1,030.20