Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.11 / $210.15 / $1,342.56	Facility	26	$200.11	$210.15	$1,342.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $427.44 / $525.67 / $1,882.64	Professional		$427.44	$525.67	$1,882.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $195.86 / $270.75 / $975.33	Professional	26	$195.86	$270.75	$975.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.11 / $286.81 / $789.85	Professional	TC	$239.11	$286.81	$789.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $420.77 / $497.79 / $976.36	Professional		$420.77	$497.79	$976.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $227.19 / $470.30 / $586.03	Professional	26	$227.19	$470.30	$586.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $519.09 / $661.22 / $1,308.10	Professional		$519.09	$661.22	$1,308.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $234.86 / $300.02 / $605.89	Professional	26	$234.86	$300.02	$605.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $276.20 / $365.22 / $715.30	Professional	TC	$276.20	$365.22	$715.30
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $387.65 / $563.36 / $1,349.95	Professional		$387.65	$563.36	$1,349.95
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $171.57 / $245.35 / $602.77	Professional	26	$171.57	$245.35	$602.77
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $216.08 / $318.61 / $741.75	Professional	TC	$216.08	$318.61	$741.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.07 / $623.23 / $1,435.12	Professional		$426.07	$623.23	$1,435.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $191.59 / $285.75 / $647.82	Professional	26	$191.59	$285.75	$647.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.05 / $348.94 / $826.28	Professional	TC	$245.05	$348.94	$826.28
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $414.16 / $601.17 / $811.59	Professional		$414.16	$601.17	$811.59
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.95 / $261.29 / $352.74	Professional	26	$173.95	$261.29	$352.74
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $240.21 / $339.89 / $458.85	Professional	TC	$240.21	$339.89	$458.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $473.36 / $607.67 / $1,082.22	Professional		$473.36	$607.67	$1,082.22
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 $262.37 / $398.99 / $638.99	Professional	TC	$262.37	$398.99	$638.99
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $528.44 / $1,135.96 / $1,135.96	Facility	26	$528.44	$1,135.96	$1,135.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,895.04 / $2,895.04 / $3,961.13	Professional		$2,895.04	$2,895.04	$3,961.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,405.16 / $1,405.16 / $1,841.48	Professional	26	$1,405.16	$1,405.16	$1,841.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,489.88 / $1,489.88 / $2,119.73	Professional	TC	$1,489.88	$1,489.88	$2,119.73
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 $426.07 / $639.10 / $1,413.19	Professional		$426.07	$639.10	$1,413.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $195.68 / $287.33 / $614.66	Professional	26	$195.68	$287.33	$614.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $248.17 / $362.91 / $820.46	Professional	TC	$248.17	$362.91	$820.46
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,622.26 / $1,622.26 / $1,622.26	Professional		$1,622.26	$1,622.26	$1,622.26
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 $877.93 / $877.93 / $877.93	Professional	TC	$877.93	$877.93	$877.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $486.14 / $579.83 / $704.08	Professional		$486.14	$579.83	$704.08
United Facility/Professional Professional Modifier Low / Median / High Price $376.85 / $621.64 / $1,664.61	Professional		$376.85	$621.64	$1,664.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $178.77 / $290.52 / $649.48	Professional	26	$178.77	$290.52	$649.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.08 / $331.11 / $799.86	Professional	TC	$198.08	$331.11	$799.86