Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.78 / $282.00 / $828.67	Facility		$35.78	$282.00	$828.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $9.22 / $51.19	Facility	26	$7.78	$9.22	$51.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.89 / $97.28 / $321.61	Facility	TC	$24.89	$97.28	$321.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $39.78 / $147.00	Professional		$26.46	$39.78	$147.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.18 / $42.45	Professional	26	$7.33	$10.18	$42.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $25.05 / $94.50	Professional	TC	$19.14	$25.05	$94.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $42.94 / $72.56	Professional		$26.94	$42.94	$72.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $8.94 / $15.18	Professional	26	$6.32	$8.94	$15.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $49.70 / $49.70	Professional	TC	$27.54	$49.70	$49.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.57 / $169.00 / $876.00	Facility		$9.57	$169.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $38.20 / $75.90	Professional		$29.48	$38.20	$75.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $11.39 / $22.91	Professional	26	$9.00	$11.39	$22.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.21 / $52.99	Professional	TC	$20.89	$27.21	$52.99
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 $27.78 / $34.95 / $87.85	Professional		$27.78	$34.95	$87.85
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.27 / $23.67	Professional	26	$8.07	$10.27	$23.67
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $24.57 / $60.16	Professional	TC	$19.48	$24.57	$60.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $225.99 / $483.01	Facility		$50.40	$225.99	$483.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $39.64 / $82.91	Professional		$26.68	$39.64	$82.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $10.60 / $23.38	Professional	26	$7.42	$10.60	$23.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $28.65 / $66.61	Professional	TC	$19.32	$28.65	$66.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $42.53 / $57.42	Professional		$25.02	$42.53	$57.42
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.34 / $12.61	Professional	26	$7.51	$9.34	$12.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $33.19 / $44.81	Professional	TC	$17.51	$33.19	$44.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $42.19 / $70.08	Professional		$31.19	$42.19	$70.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.21 / $17.73	Professional	26	$8.23	$11.21	$17.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $38.46 / $62.33	Professional	TC	$26.55	$38.46	$62.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $124.07 / $359.91 / $359.91	Facility		$124.07	$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 / $133.13 / $133.13	Facility	TC	$100.00	$133.13	$133.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.83 / $208.83 / $275.39	Professional		$208.83	$208.83	$275.39
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $82.56 / $82.56	Professional	26	$82.56	$82.56	$82.56
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $176.00 / $176.00 / $207.68	Professional	TC	$176.00	$176.00	$207.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $32.34 / $32.34	Professional		$26.89	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.25 / $44.29 / $81.88	Facility		$29.25	$44.29	$81.88
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $43.33 / $87.15	Professional		$27.30	$43.33	$87.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.46 / $10.39 / $22.87	Professional	26	$7.46	$10.39	$22.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $28.29 / $62.81	Professional	TC	$19.32	$28.29	$62.81
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $103.82 / $103.82 / $103.82	Professional		$103.82	$103.82	$103.82
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $28.64 / $28.64	Professional	26	$28.64	$28.64	$28.64
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $75.18 / $75.18 / $75.18	Professional	TC	$75.18	$75.18	$75.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.39 / $47.29 / $65.11	Professional		$34.39	$47.29	$65.11
United Facility/Professional Facility Modifier Low / Median / High Price $37.52 / $181.13 / $181.13	Facility		$37.52	$181.13	$181.13
United Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $33.61 / $89.82	Professional		$23.02	$33.61	$89.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.13 / $25.00	Professional	26	$6.64	$9.13	$25.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $22.74 / $58.08	Professional	TC	$16.77	$22.74	$58.08