Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $368.80 / $387.09 / $2,499.26	Facility	26	$368.80	$387.09	$2,499.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,889.42 / $2,326.09 / $9,722.00	Professional		$1,889.42	$2,326.09	$9,722.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $360.87 / $500.73 / $1,965.00	Professional	26	$360.87	$500.73	$1,965.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,509.45 / $1,891.72 / $4,881.41	Professional	TC	$1,509.45	$1,891.72	$4,881.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,676.72 / $2,164.69 / $3,899.06	Professional		$1,676.72	$2,164.69	$3,899.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $423.76 / $877.01 / $1,080.57	Professional	26	$423.76	$877.01	$1,080.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,850.78 / $2,743.99 / $5,726.84	Professional		$1,850.78	$2,743.99	$5,726.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $428.28 / $536.39 / $1,114.88	Professional	26	$428.28	$536.39	$1,114.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,421.16 / $2,211.38 / $4,535.88	Professional	TC	$1,421.16	$2,211.38	$4,535.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $1,543.66 / $2,261.58 / $5,375.69	Professional		$1,543.66	$2,261.58	$5,375.69
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $260.83 / $372.61 / $936.23	Professional	26	$260.83	$372.61	$936.23
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $1,282.83 / $1,890.51 / $4,421.43	Professional	TC	$1,282.83	$1,890.51	$4,421.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,649.98 / $2,462.19 / $5,727.41	Professional		$1,649.98	$2,462.19	$5,727.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $355.09 / $502.38 / $1,138.99	Professional	26	$355.09	$502.38	$1,138.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,320.21 / $2,019.08 / $4,711.13	Professional	TC	$1,320.21	$2,019.08	$4,711.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,237.18 / $2,443.50 / $3,298.73	Professional		$1,237.18	$2,443.50	$3,298.73
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $247.44 / $487.13 / $657.63	Professional	26	$247.44	$487.13	$657.63
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $989.74 / $1,956.38 / $2,641.11	Professional	TC	$989.74	$1,956.38	$2,641.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,866.78 / $2,439.90 / $4,396.54	Professional		$1,866.78	$2,439.90	$4,396.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $418.29 / $602.28 / $1,005.49	Professional	26	$418.29	$602.28	$1,005.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $1,509.45 / $2,295.78 / $3,677.99	Professional	TC	$1,509.45	$2,295.78	$3,677.99
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $985.21 / $2,118.79 / $2,118.79	Facility	26	$985.21	$2,118.79	$2,118.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,628.82 / $13,988.24 / $15,609.38	Professional		$11,628.82	$13,988.24	$15,609.38
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2,613.17 / $2,958.87 / $3,439.95	Professional	26	$2,613.17	$2,958.87	$3,439.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $9,015.64 / $9,015.64 / $12,169.43	Professional	TC	$9,015.64	$9,015.64	$12,169.43
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 $1,641.26 / $2,536.67 / $5,647.47	Professional		$1,641.26	$2,536.67	$5,647.47
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $355.42 / $505.28 / $1,124.41	Professional	26	$355.42	$505.28	$1,124.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $1,320.21 / $2,026.30 / $4,664.32	Professional	TC	$1,320.21	$2,026.30	$4,664.32
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $6,421.62 / $6,421.62 / $6,421.62	Professional		$6,421.62	$6,421.62	$6,421.62
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $1,385.73 / $1,385.73 / $1,385.73	Professional	26	$1,385.73	$1,385.73	$1,385.73
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $5,035.89 / $5,035.89 / $5,035.89	Professional	TC	$5,035.89	$5,035.89	$5,035.89
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $1,608.34 / $2,047.16 / $2,717.34	Professional		$1,608.34	$2,047.16	$2,717.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,503.70 / $2,436.50 / $5,929.81	Professional		$1,503.70	$2,436.50	$5,929.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $310.29 / $540.89 / $1,171.80	Professional	26	$310.29	$540.89	$1,171.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,218.65 / $1,895.61 / $5,945.13	Professional	TC	$1,218.65	$1,895.61	$5,945.13