Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $363.08 / $812.83	Facility		$38.90	$363.08	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.72 / $22.91	Facility	26	$7.94	$10.72	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $100.00 / $501.19	Facility	TC	$22.91	$100.00	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $131.83	Professional		$24.55	$37.15	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.30 / $43.65	Professional	26	$7.76	$12.30	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $87.10	Professional	TC	$15.85	$23.99	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $29.51 / $51.29	Professional		$20.42	$29.51	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.96 / $19.05	Professional	26	$6.92	$10.96	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $25.12 / $38.02	Professional	TC	$15.49	$25.12	$38.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $10.96 / $147.91	Facility		$9.77	$10.96	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.90 / $75.86	Professional		$27.54	$38.90	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $23.99	Professional	26	$9.12	$12.30	$23.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $54.95	Professional	TC	$18.62	$26.92	$54.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $102.33 / $281.84	Facility		$54.95	$102.33	$281.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $77.62	Professional		$33.88	$44.67	$77.62
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $22.91	Professional	26	$9.55	$12.59	$22.91
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $31.62 / $54.95	Professional	TC	$24.55	$31.62	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $245.47 / $691.83	Facility		$40.74	$245.47	$691.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $72.44	Professional		$24.55	$37.15	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.96 / $21.38	Professional	26	$7.59	$10.96	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $53.70	Professional	TC	$16.98	$25.70	$53.70
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $50.12	Professional		$21.38	$37.15	$50.12
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $9.55 / $13.18	Professional	26	$5.62	$9.55	$13.18
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $27.54 / $37.15	Professional	TC	$15.85	$27.54	$37.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $34.67 / $60.26	Professional		$27.54	$34.67	$60.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $18.20	Professional	26	$8.32	$11.22	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $51.29	Professional	TC	$22.91	$29.51	$51.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $363.08 / $363.08	Facility		$177.83	$363.08	$363.08
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	TC	$125.89	$125.89	$125.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $234.42 / $234.42	Professional		$42.66	$234.42	$234.42
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $169.82 / $169.82	Professional	TC	$162.18	$169.82	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $31.62 / $33.11	Professional		$10.00	$31.62	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $39.81 / $77.62	Facility		$25.70	$39.81	$77.62
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.02 / $74.13	Professional		$24.55	$38.02	$74.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.47 / $20.42	Professional	26	$7.41	$10.47	$20.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.55 / $52.48	Professional	TC	$16.60	$24.55	$52.48
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	26	$28.84	$28.84	$28.84
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	TC	$66.07	$66.07	$66.07
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $52.48	Professional		$30.20	$40.74	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $165.96 / $263.03	Facility		$19.95	$165.96	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.84 / $60.26	Professional		$20.42	$28.84	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $18.20	Professional	26	$6.46	$9.12	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.95 / $43.65	Professional	TC	$14.13	$19.95	$43.65