Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.06 / $253.80 / $542.29	Facility		$212.06	$253.80	$542.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.34 / $84.25 / $218.97	Facility	26	$81.34	$84.25	$218.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.60 / $194.00 / $423.02	Professional		$41.60	$194.00	$423.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.63 / $79.95 / $159.29	Professional	26	$36.63	$79.95	$159.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.59 / $128.59 / $200.00	Professional	TC	$27.59	$128.59	$200.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.31 / $73.31 / $73.31	Professional	26	$73.31	$73.31	$73.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.00 / $4,549.00 / $9,589.00	Facility		$1,787.00	$4,549.00	$9,589.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.19 / $204.65 / $361.36	Professional		$66.19	$204.65	$361.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.09 / $90.34 / $148.78	Professional	26	$37.09	$90.34	$148.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $126.06 / $220.96	Professional	TC	$25.14	$126.06	$220.96
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $163.35 / $253.99 / $517.09	Professional		$163.35	$253.99	$517.09
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $63.52 / $92.58 / $193.87	Professional	26	$63.52	$92.58	$193.87
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $102.89 / $161.88 / $337.37	Professional	TC	$102.89	$161.88	$337.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.08 / $52.08 / $52.08	Facility		$52.08	$52.08	$52.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.62 / $205.31 / $373.41	Professional		$76.62	$205.31	$373.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $80.93 / $151.97	Professional	26	$41.66	$80.93	$151.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.57 / $120.85 / $231.63	Professional	TC	$34.57	$120.85	$231.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $77.89 / $105.15	Professional		$72.59	$77.89	$105.15
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $40.11 / $54.15	Professional	26	$31.94	$40.11	$54.15
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.78 / $40.65 / $51.27	Professional	TC	$37.78	$40.65	$51.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $76.26 / $146.43	Professional		$60.73	$76.26	$146.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $40.50 / $72.48	Professional	26	$33.44	$40.50	$72.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.17 / $37.78 / $68.19	Professional	TC	$29.17	$37.78	$68.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $410.45 / $2,922.50	Facility		$55.00	$410.45	$2,922.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $133.40 / $323.94 / $323.94	Facility	26	$133.40	$323.94	$323.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,172.83 / $1,317.18 / $1,317.18	Professional		$1,172.83	$1,317.18	$1,317.18
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $638.00 / $638.00 / $638.00	Professional	26	$638.00	$638.00	$638.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $870.88 / $870.88 / $870.88	Professional	TC	$870.88	$870.88	$870.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $181.58	Professional		$32.34	$32.34	$181.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.83 / $110.93 / $298.02	Facility		$67.83	$110.93	$298.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $165.18 / $337.75	Professional		$80.78	$165.18	$337.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $81.09 / $137.69	Professional	26	$43.99	$81.09	$137.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $36.51 / $129.79 / $239.63	Professional	TC	$36.51	$129.79	$239.63
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $222.05 / $222.05 / $222.05	Professional		$222.05	$222.05	$222.05
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $124.03 / $124.03 / $124.03	Professional	26	$124.03	$124.03	$124.03
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $98.02 / $98.02 / $98.02	Professional	TC	$98.02	$98.02	$98.02
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $62.96 / $86.57 / $137.33	Professional		$62.96	$86.57	$137.33
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,506.00 / $6,323.00	Facility		$548.00	$1,506.00	$6,323.00
United Facility/Professional Professional Modifier Low / Median / High Price $55.68 / $123.63 / $283.95	Professional		$55.68	$123.63	$283.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.90 / $63.57 / $123.36	Professional	26	$31.90	$63.57	$123.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.76 / $54.62 / $169.45	Professional	TC	$23.76	$54.62	$169.45