Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.65 / $233.51 / $701.76	Facility		$41.65	$233.51	$701.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.61 / $11.89 / $60.56	Facility	26	$10.61	$11.89	$60.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.76 / $108.89 / $233.59	Facility	TC	$29.76	$108.89	$233.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.93 / $40.93 / $176.47	Professional		$31.93	$40.93	$176.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $12.74 / $56.54	Professional	26	$8.88	$12.74	$56.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.43 / $27.31 / $73.03	Professional	TC	$22.43	$27.31	$73.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.69 / $36.45 / $51.03	Professional		$29.69	$36.45	$51.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $14.37 / $42.84	Professional	26	$6.58	$14.37	$42.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.23 / $184.81 / $876.00	Facility		$13.23	$184.81	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.56 / $46.00 / $90.26	Professional		$34.56	$46.00	$90.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $15.35 / $29.37	Professional	26	$10.80	$15.35	$29.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.20 / $31.11 / $61.83	Professional	TC	$24.20	$31.11	$61.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $55.14 / $97.90 / $257.04	Facility		$55.14	$97.90	$257.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $34.45 / $44.49 / $100.00	Professional		$34.45	$44.49	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $14.93 / $31.33	Professional	26	$11.66	$14.93	$31.33
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.50 / $29.60 / $71.90	Professional	TC	$23.50	$29.60	$71.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.73 / $272.93 / $681.32	Facility		$56.73	$272.93	$681.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.28 / $46.60 / $100.70	Professional		$32.28	$46.60	$100.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $14.03 / $28.61	Professional	26	$9.06	$14.03	$28.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.86 / $33.10 / $75.13	Professional	TC	$21.86	$33.10	$75.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $47.01 / $63.46	Professional		$25.98	$47.01	$63.46
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $9.69 / $13.08	Professional	26	$8.83	$9.69	$13.08
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $37.32 / $50.38	Professional	TC	$17.14	$37.32	$50.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $46.30 / $78.58	Professional		$34.43	$46.30	$78.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $11.63 / $18.22	Professional	26	$8.56	$11.63	$18.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.86 / $43.23 / $70.08	Professional	TC	$29.86	$43.23	$70.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.06 / $359.91 / $359.91	Facility		$104.06	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.90 / $100.00 / $100.00	Facility	26	$31.90	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $149.66 / $149.66	Facility	TC	$100.00	$149.66	$149.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $230.47 / $230.47 / $303.45	Professional		$230.47	$230.47	$303.45
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $77.59 / $77.59	Professional	26	$77.59	$77.59	$77.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $214.00 / $214.00 / $233.18	Professional	TC	$214.00	$214.00	$233.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $32.34 / $32.34	Professional		$30.18	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.51 / $49.69 / $92.67	Facility		$33.51	$49.69	$92.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.02 / $52.81 / $100.66	Professional		$33.02	$52.81	$100.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $13.97 / $28.61	Professional	26	$9.25	$13.97	$28.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.91 / $32.82 / $71.55	Professional	TC	$21.91	$32.82	$71.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $118.20 / $118.20 / $118.20	Professional		$118.20	$118.20	$118.20
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $33.40 / $33.40	Professional	26	$33.40	$33.40	$33.40
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $84.79 / $84.79 / $84.79	Professional	TC	$84.79	$84.79	$84.79
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.16 / $63.34	Professional		$38.02	$52.16	$63.34
United Facility/Professional Facility Modifier Low / Median / High Price $41.35 / $173.25 / $206.21	Facility		$41.35	$173.25	$206.21
United Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $38.67 / $98.07	Professional		$27.00	$38.67	$98.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.13 / $12.28 / $28.30	Professional	26	$9.13	$12.28	$28.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.75 / $26.27 / $65.51	Professional	TC	$18.75	$26.27	$65.51