Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.28 / $388.56 / $913.50	Facility		$43.28	$388.56	$913.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.49 / $10.93 / $53.19	Facility	26	$8.49	$10.93	$53.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.56 / $267.24 / $484.09	Facility	TC	$15.56	$267.24	$484.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.79 / $26.89 / $109.00	Professional		$17.79	$26.89	$109.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.73 / $42.00	Professional	26	$8.13	$11.73	$42.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.74 / $14.80 / $46.60	Professional	TC	$9.74	$14.80	$46.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $27.46 / $57.11	Professional		$23.13	$27.46	$57.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $8.67 / $19.48	Professional	26	$6.42	$8.67	$19.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.11 / $35.83 / $35.83	Professional	TC	$32.11	$35.83	$35.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.19 / $169.00 / $876.00	Facility		$12.19	$169.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.71 / $38.61 / $74.94	Professional		$23.71	$38.61	$74.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.82 / $16.80 / $29.02	Professional	26	$8.82	$16.80	$29.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.35 / $21.75 / $43.49	Professional	TC	$14.35	$21.75	$43.49
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $41.22 / $84.20 / $141.59	Facility		$41.22	$84.20	$141.59
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $18.02 / $23.44 / $59.15	Professional		$18.02	$23.44	$59.15
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.62 / $10.46 / $26.28	Professional	26	$7.62	$10.46	$26.28
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $10.02 / $13.23 / $35.75	Professional	TC	$10.02	$13.23	$35.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.63 / $225.99 / $483.01	Facility		$35.63	$225.99	$483.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.77 / $28.33 / $65.40	Professional		$19.77	$28.33	$65.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.53 / $24.36	Professional	26	$7.65	$11.53	$24.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.93 / $16.39 / $43.33	Professional	TC	$10.93	$16.39	$43.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $17.64 / $33.24 / $44.87	Professional		$17.64	$33.24	$44.87
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.69 / $13.08	Professional	26	$7.94	$9.69	$13.08
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.71 / $23.55 / $31.79	Professional	TC	$9.71	$23.55	$31.79
HealthNet Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $11.34 / $21.56	Professional	26	$8.81	$11.34	$21.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.26 / $33.24 / $54.06	Professional		$25.26	$33.24	$54.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $11.63 / $18.41	Professional	26	$8.56	$11.63	$18.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $27.32 / $44.28	Professional	TC	$18.84	$27.32	$44.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $81.68 / $359.91 / $359.91	Facility		$81.68	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.47 / $70.00 / $70.00	Facility	26	$20.47	$70.00	$70.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $50.00 / $94.62 / $94.62	Facility	TC	$50.00	$94.62	$94.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $165.42 / $165.42 / $218.63	Professional		$165.42	$165.42	$218.63
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $55.28 / $70.34	Professional	26	$55.28	$55.28	$70.34
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.07 / $110.07 / $148.28	Professional	TC	$110.07	$110.07	$148.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.18 / $32.34 / $32.34	Professional		$19.18	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.31 / $34.44 / $135.05	Facility		$21.31	$34.44	$135.05
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $19.39	Facility	TC	$19.39	$19.39	$19.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.71 / $32.74 / $69.18	Professional		$20.71	$32.74	$69.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $11.45 / $24.34	Professional	26	$7.71	$11.45	$24.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.14 / $16.03 / $39.72	Professional	TC	$11.14	$16.03	$39.72
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $84.54 / $84.54 / $84.54	Professional		$84.54	$84.54	$84.54
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $29.79 / $29.79 / $29.79	Professional	26	$29.79	$29.79	$29.79
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $54.74 / $54.74 / $54.74	Professional	TC	$54.74	$54.74	$54.74
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $22.94 / $30.00 / $36.96	Professional		$22.94	$30.00	$36.96
United Facility/Professional Facility Modifier Low / Median / High Price $35.13 / $35.13 / $59.31	Facility		$35.13	$35.13	$59.31
United Facility/Professional Professional Modifier Low / Median / High Price $15.92 / $25.98 / $76.06	Professional		$15.92	$25.98	$76.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.39 / $9.86 / $26.80	Professional	26	$7.39	$9.86	$26.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.52 / $16.60 / $47.78	Professional	TC	$8.52	$16.60	$47.78