Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.33 / $56.61 / $342.92	Facility	26	$51.33	$56.61	$342.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $383.53 / $852.44	Professional		$316.31	$383.53	$852.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.84 / $328.35 / $682.22	Professional	TC	$249.84	$328.35	$682.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $357.39 / $357.39 / $357.39	Professional		$357.39	$357.39	$357.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.28 / $368.43 / $687.99	Professional		$247.28	$368.43	$687.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.10 / $270.05 / $563.48	Professional	TC	$182.10	$270.05	$563.48
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $180.09 / $270.91 / $677.41	Professional		$180.09	$270.91	$677.41
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $145.52 / $211.06 / $539.58	Professional	TC	$145.52	$211.06	$539.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.56 / $487.22 / $1,177.31	Professional		$256.56	$487.22	$1,177.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.24 / $415.29 / $1,032.47	Professional	TC	$197.24	$415.29	$1,032.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $65.01 / $82.45 / $756.16	Professional		$65.01	$82.45	$756.16
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.90 / $37.93 / $85.55	Professional	26	$29.90	$37.93	$85.55
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.11 / $44.52 / $670.61	Professional	TC	$35.11	$44.52	$670.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $415.78 / $526.80 / $849.53	Professional		$415.78	$526.80	$849.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.31 / $64.04 / $114.38	Professional	26	$52.31	$64.04	$114.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $382.91 / $496.75 / $803.70	Professional	TC	$382.91	$496.75	$803.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.97 / $347.00 / $347.00	Facility	26	$128.97	$347.00	$347.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,673.66 / $2,673.66 / $3,521.78	Professional		$2,673.66	$2,673.66	$3,521.78
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,317.40 / $2,317.40 / $3,073.88	Professional	TC	$2,317.40	$2,317.40	$3,073.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $559.19	Professional		$32.34	$32.34	$559.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $293.42 / $595.19 / $1,110.55	Professional		$293.42	$595.19	$1,110.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $197.24 / $414.05 / $935.73	Professional	TC	$197.24	$414.05	$935.73
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $1,322.21 / $1,322.21 / $1,322.21	Professional		$1,322.21	$1,322.21	$1,322.21
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,132.05 / $1,132.05 / $1,132.05	Professional	TC	$1,132.05	$1,132.05	$1,132.05
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $82.45 / $158.52 / $622.99	Professional		$82.45	$158.52	$622.99
United Facility/Professional Professional Modifier Low / Median / High Price $250.37 / $388.15 / $1,201.11	Professional		$250.37	$388.15	$1,201.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.77 / $330.39 / $957.73	Professional	TC	$195.77	$330.39	$957.73