Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $93.33 / $446.68	Facility	26	$70.79	$93.33	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $501.19 / $2,344.23	Professional		$323.59	$501.19	$2,344.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $112.20 / $346.74	Professional	26	$67.61	$112.20	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $354.81 / $1,548.82	Professional	TC	$275.42	$354.81	$1,548.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $323.59	Professional		$245.47	$245.47	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $117.49	Professional	26	$74.13	$74.13	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $676.08 / $1,348.96	Professional		$478.63	$676.08	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $239.88	Professional	26	$83.18	$117.49	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $562.34 / $1,148.15	Professional	TC	$389.05	$562.34	$1,148.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $707.95 / $1,584.89	Professional		$467.74	$707.95	$1,584.89
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $114.82 / $257.04	Professional	26	$83.18	$114.82	$257.04
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $575.44 / $1,318.26	Professional	TC	$389.05	$575.44	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $1,318.26	Professional		$338.84	$575.44	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $208.93	Professional	26	$66.07	$100.00	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $489.78 / $1,122.02	Professional	TC	$323.59	$489.78	$1,122.02
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $524.81 / $575.44	Professional		$363.08	$524.81	$575.44
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $81.28 / $89.13	Professional	26	$61.66	$81.28	$89.13
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $436.52 / $478.63	Professional	TC	$302.00	$436.52	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $512.86 / $977.24	Professional		$389.05	$512.86	$977.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $169.82	Professional	26	$70.79	$93.33	$169.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $457.09 / $831.76	Professional	TC	$338.84	$457.09	$831.76
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $457.09 / $457.09	Facility	26	$457.09	$457.09	$457.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,311.31 / $3,311.31	Professional		$2,691.53	$3,311.31	$3,311.31
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $575.44 / $575.44	Professional	26	$457.09	$575.44	$575.44
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,238.72 / $2,691.53 / $2,691.53	Professional	TC	$2,238.72	$2,691.53	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $575.44 / $1,318.26	Professional		$331.13	$575.44	$1,318.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $97.72 / $204.17	Professional	26	$67.61	$97.72	$204.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $501.19 / $1,122.02	Professional	TC	$323.59	$501.19	$1,122.02
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	26	$251.19	$251.19	$251.19
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Professional	TC	$1,258.93	$1,258.93	$1,258.93
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $478.63 / $616.60	Professional		$363.08	$478.63	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $457.09 / $1,230.27	Professional		$302.00	$457.09	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $85.11 / $204.17	Professional	26	$66.07	$85.11	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $371.54 / $1,023.29	Professional	TC	$234.42	$371.54	$1,023.29