Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.63 / $117.71 / $710.15	Facility	26	$105.63	$117.71	$710.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $342.31 / $411.52 / $804.21	Professional	TC	$342.31	$411.52	$804.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $343.15 / $471.35 / $948.40	Professional	TC	$343.15	$471.35	$948.40
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $262.61 / $395.97 / $935.21	Professional	TC	$262.61	$395.97	$935.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $394.28 / $556.42 / $1,305.18	Professional	TC	$394.28	$556.42	$1,305.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.57 / $121.21 / $178.86	Professional	26	$95.57	$121.21	$178.86
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $319.97 / $405.81 / $807.12	Professional	TC	$319.97	$405.81	$807.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.43 / $133.87 / $239.14	Professional	26	$109.43	$133.87	$239.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $460.87 / $597.87 / $967.31	Professional	TC	$460.87	$597.87	$967.31
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $269.57 / $526.83 / $578.12	Facility	26	$269.57	$526.83	$578.12
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,779.03 / $2,779.03 / $3,700.20	Professional	TC	$2,779.03	$2,779.03	$3,700.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $401.13 / $559.11 / $1,212.77	Professional	TC	$401.13	$559.11	$1,212.77
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $1,371.28 / $1,371.28 / $1,371.28	Professional	TC	$1,371.28	$1,371.28	$1,371.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $312.31 / $441.34 / $1,346.44	Professional	TC	$312.31	$441.34	$1,346.44