Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.86 / $281.51 / $572.32	Facility		$40.86	$281.51	$572.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.98 / $11.71 / $65.94	Facility	26	$9.98	$11.71	$65.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.80 / $40.36 / $158.00	Professional		$27.80	$40.36	$158.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.53 / $58.00	Professional	26	$9.41	$12.53	$58.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.17 / $65.09	Professional	TC	$19.76	$25.17	$65.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.27 / $39.35 / $64.90	Professional		$30.27	$39.35	$64.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $14.44 / $24.32	Professional	26	$7.36	$14.44	$24.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $12.43 / $187.96 / $876.00	Facility		$12.43	$187.96	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $42.63 / $82.81	Professional		$33.04	$42.63	$82.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $14.60 / $28.20	Professional	26	$11.42	$14.60	$28.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $28.48 / $56.04	Professional	TC	$22.20	$28.48	$56.04
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $97.40 / $231.59	Facility		$54.55	$97.40	$231.59
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $40.53 / $98.13	Professional		$32.02	$40.53	$98.13
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $13.21 / $30.44	Professional	26	$10.34	$13.21	$30.44
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.67 / $27.31 / $63.02	Professional	TC	$21.67	$27.31	$63.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.62 / $225.99 / $483.01	Facility		$54.62	$225.99	$483.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.73 / $43.98 / $93.50	Professional		$29.73	$43.98	$93.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $13.58 / $30.09	Professional	26	$9.52	$13.58	$30.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.45 / $30.39 / $71.14	Professional	TC	$20.45	$30.39	$71.14
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $47.50 / $64.13	Professional		$27.16	$47.50	$64.13
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.96 / $12.02 / $16.23	Professional	26	$8.96	$12.02	$16.23
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $35.49 / $47.91	Professional	TC	$18.20	$35.49	$47.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.92 / $47.24 / $75.95	Professional		$34.92	$47.24	$75.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $14.42 / $22.82	Professional	26	$10.58	$14.42	$22.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $41.10 / $66.63	Professional	TC	$28.39	$41.10	$66.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $112.24 / $359.91 / $359.91	Facility		$112.24	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $100.00 / $100.00	Facility	26	$36.81	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $236.90 / $236.90 / $308.18	Professional		$236.90	$236.90	$308.18
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $82.56 / $86.33	Professional	26	$82.56	$82.56	$86.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $190.00 / $221.85	Professional	TC	$190.00	$190.00	$221.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $32.34 / $32.34	Professional		$29.08	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.39 / $49.37 / $88.52	Facility		$32.39	$49.37	$88.52
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $48.07 / $98.84	Professional		$30.74	$48.07	$98.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $13.29 / $30.07	Professional	26	$9.57	$13.29	$30.07
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.87 / $29.63 / $64.45	Professional	TC	$20.87	$29.63	$64.45
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $118.00	Professional		$118.00	$118.00	$118.00
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $36.79 / $36.79	Professional	26	$36.79	$36.79	$36.79
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $81.19 / $81.19 / $81.19	Professional	TC	$81.19	$81.19	$81.19
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.42 / $52.82 / $69.58	Professional		$38.42	$52.82	$69.58
United Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $189.00 / $189.00	Facility		$42.11	$189.00	$189.00
United Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $37.20 / $89.06	Professional		$25.85	$37.20	$89.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $12.38 / $32.07	Professional	26	$8.57	$12.38	$32.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $24.89 / $62.71	Professional	TC	$17.05	$24.89	$62.71