Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.74 / $39.84 / $258.51	Facility	26	$37.74	$39.84	$258.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.46 / $472.45 / $2,043.00	Professional		$392.46	$472.45	$2,043.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $47.46 / $194.23	Professional	26	$36.71	$47.46	$194.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $357.48 / $401.85 / $1,109.38	Professional	TC	$357.48	$401.85	$1,109.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $320.77 / $320.77 / $320.77	Professional		$320.77	$320.77	$320.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.52 / $67.75 / $109.64	Professional	26	$47.52	$67.75	$109.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.66 / $493.74 / $1,038.94	Professional		$361.66	$493.74	$1,038.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.88 / $54.48 / $111.57	Professional	26	$39.88	$54.48	$111.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $321.38 / $438.79 / $942.80	Professional	TC	$321.38	$438.79	$942.80
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $338.56 / $532.02 / $1,289.51	Professional		$338.56	$532.02	$1,289.51
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $45.84 / $111.39	Professional	26	$38.81	$45.84	$111.39
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $308.38 / $484.59 / $1,178.08	Professional	TC	$308.38	$484.59	$1,178.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.60 / $576.59 / $1,336.92	Professional		$388.60	$576.59	$1,336.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.71 / $54.68 / $122.41	Professional	26	$37.71	$54.68	$122.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.11 / $550.11 / $1,279.40	Professional	TC	$371.11	$550.11	$1,279.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $391.93 / $523.32 / $706.48	Professional		$391.93	$523.32	$706.48
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.27 / $46.48 / $62.75	Professional	26	$35.27	$46.48	$62.75
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $356.66 / $476.84 / $643.73	Professional	TC	$356.66	$476.84	$643.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $388.14 / $511.81 / $914.64	Professional		$388.14	$511.81	$914.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.21 / $55.62 / $97.57	Professional	26	$38.21	$55.62	$97.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $365.97 / $528.52 / $896.46	Professional	TC	$365.97	$528.52	$896.46
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $99.49 / $189.21 / $205.20	Facility	26	$99.49	$189.21	$205.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,679.53 / $2,679.53 / $3,293.78	Professional		$2,679.53	$2,679.53	$3,293.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $266.22 / $266.22 / $336.30	Professional	26	$266.22	$266.22	$336.30
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,413.31 / $2,413.31 / $2,957.48	Professional	TC	$2,413.31	$2,413.31	$2,957.48
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 $388.60 / $576.39 / $1,335.50	Professional		$388.60	$576.39	$1,335.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $54.70 / $120.28	Professional	26	$38.61	$54.70	$120.28
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $390.91 / $551.66 / $1,279.40	Professional	TC	$390.91	$551.66	$1,279.40
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,512.50 / $1,512.50 / $1,512.50	Professional		$1,512.50	$1,512.50	$1,512.50
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $145.38 / $145.38 / $145.38	Professional	26	$145.38	$145.38	$145.38
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,367.12 / $1,367.12 / $1,367.12	Professional	TC	$1,367.12	$1,367.12	$1,367.12
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $423.30 / $548.70 / $666.28	Professional		$423.30	$548.70	$666.28
United Facility/Professional Professional Modifier Low / Median / High Price $375.43 / $487.09 / $1,315.94	Professional		$375.43	$487.09	$1,315.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $47.81 / $130.63	Professional	26	$35.24	$47.81	$130.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $340.19 / $434.81 / $1,193.28	Professional	TC	$340.19	$434.81	$1,193.28