Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $512.86	Professional		$181.97	$239.88	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $120.23	Professional	26	$30.90	$45.71	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $190.55 / $478.63	Professional	TC	$144.54	$190.55	$478.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $91.20	Professional	26	$66.07	$70.79	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $933.25	Professional		$275.42	$363.08	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $72.44 / $147.91	Professional	26	$50.12	$72.44	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $295.12 / $776.25	Professional	TC	$223.87	$295.12	$776.25
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $588.84	Professional		$199.53	$263.03	$588.84
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.55 / $14.79	Professional	26	$7.76	$9.55	$14.79
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $234.42 / $338.84	Professional	TC	$173.78	$234.42	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $229.09 / $616.60	Professional		$109.65	$229.09	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.30 / $79.43	Professional	26	$22.39	$26.30	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $177.83 / $524.81	Professional	TC	$87.10	$177.83	$524.81
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $363.08 / $489.78	Professional		$186.21	$363.08	$489.78
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $45.71 / $61.66	Professional	26	$38.90	$45.71	$61.66
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $316.23 / $426.58	Professional	TC	$144.54	$316.23	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $537.03	Professional		$281.84	$338.84	$537.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $52.48 / $69.18	Professional	26	$36.31	$52.48	$69.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $346.74 / $478.63	Professional	TC	$239.88	$346.74	$478.63
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,290.87 / $2,290.87	Professional		$2,089.30	$2,290.87	$2,290.87
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $323.59 / $323.59	Professional	26	$269.15	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,819.70 / $1,949.84 / $1,949.84	Professional	TC	$1,819.70	$1,949.84	$1,949.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $239.88 / $776.25	Professional		$117.49	$239.88	$776.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $39.81 / $95.50	Professional	26	$22.91	$39.81	$95.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $199.53 / $602.56	Professional	TC	$89.13	$199.53	$602.56
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Professional		$1,318.26	$1,318.26	$1,318.26
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	26	$169.82	$169.82	$169.82
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional	TC	$1,148.15	$1,148.15	$1,148.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $407.38	Professional		$302.00	$302.00	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $812.83	Professional		$128.82	$208.93	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.84 / $104.71	Professional	26	$25.70	$28.84	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $181.97 / $707.95	Professional	TC	$102.33	$181.97	$707.95