Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $416.87 / $691.83	Facility		$229.09	$416.87	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $83.18 / $213.80	Facility	26	$81.28	$83.18	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $109.65 / $426.58	Professional		$38.90	$109.65	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $77.62 / $194.98	Professional	26	$34.67	$77.62	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $72.44 / $208.93	Professional	TC	$25.70	$72.44	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $30.20 / $45.71	Professional		$28.84	$30.20	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $81.28 / $389.05	Professional	26	$42.66	$81.28	$389.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,466.84 / $12,882.50	Facility		$2,570.40	$4,466.84	$12,882.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $199.53 / $363.08	Professional		$89.13	$199.53	$363.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $100.00 / $158.49	Professional	26	$50.12	$100.00	$158.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $104.71 / $223.87	Professional	TC	$22.39	$104.71	$223.87
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $177.83 / $1,778.28	Facility		$66.07	$177.83	$1,778.28
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $275.42 / $478.63	Professional		$107.15	$275.42	$478.63
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $100.00 / $177.83	Professional	26	$56.23	$100.00	$177.83
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $177.83 / $309.03	Professional	TC	$52.48	$177.83	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $208.93 / $338.84	Professional		$75.86	$208.93	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $81.28 / $134.90	Professional	26	$41.69	$81.28	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $120.23 / $213.80	Professional	TC	$33.88	$120.23	$213.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $83.18 / $109.65	Professional		$72.44	$83.18	$109.65
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $42.66 / $54.95	Professional	26	$31.62	$42.66	$54.95
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $40.74 / $54.95	Professional	TC	$40.74	$40.74	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $134.90	Professional		$64.57	$75.86	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $38.90 / $66.07	Professional	26	$34.67	$38.90	$66.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $38.02 / $63.10	Professional	TC	$31.62	$38.02	$63.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,951.21	Facility		$54.95	$56.23	$2,951.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,318.26	Professional		$1,174.90	$1,174.90	$1,318.26
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $630.96 / $630.96 / $630.96	Professional	26	$630.96	$630.96	$630.96
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $870.96 / $870.96 / $870.96	Professional	TC	$870.96	$870.96	$870.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $181.97	Professional		$77.62	$104.71	$181.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $120.23 / $331.13	Facility		$69.18	$120.23	$331.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $181.97 / $338.84	Professional		$77.62	$181.97	$338.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $81.28 / $128.82	Professional	26	$41.69	$81.28	$128.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $128.82 / $229.09	Professional	TC	$34.67	$128.82	$229.09
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	26	$123.03	$123.03	$123.03
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	TC	$97.72	$97.72	$97.72
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $154.88	Professional		$72.44	$102.33	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,584.89 / $6,456.54	Facility		$588.84	$1,584.89	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $123.03 / $288.40	Professional		$56.23	$123.03	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $64.57 / $123.03	Professional	26	$32.36	$64.57	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $54.95 / $177.83	Professional	TC	$24.55	$54.95	$177.83