Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $218.78 / $851.14	Facility		$38.90	$218.78	$851.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.00 / $22.91	Facility	26	$7.41	$10.00	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $97.72 / $323.59	Facility	TC	$26.30	$97.72	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $151.36	Professional		$28.18	$45.71	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.49 / $42.66	Professional	26	$7.24	$13.49	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $31.62 / $104.71	Professional	TC	$19.05	$31.62	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $34.67 / $61.66	Professional		$25.12	$34.67	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.49 / $19.05	Professional	26	$7.76	$13.49	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.70 / $44.67	Professional	TC	$15.14	$25.70	$44.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $10.72 / $169.82	Facility		$9.55	$10.72	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $83.18	Professional		$30.20	$42.66	$83.18
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 $21.38 / $30.20 / $61.66	Professional	TC	$21.38	$30.20	$61.66
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $102.33 / $263.03	Facility		$57.54	$102.33	$263.03
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $42.66 / $85.11	Professional		$31.62	$42.66	$85.11
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $21.88	Professional	26	$9.12	$12.02	$21.88
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $63.10	Professional	TC	$21.88	$30.90	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $199.53 / $524.81	Facility		$50.12	$199.53	$524.81
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 $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $74.13	Professional		$26.92	$39.81	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.72 / $21.38	Professional	26	$7.41	$10.72	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.18 / $56.23	Professional	TC	$19.50	$28.18	$56.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $57.54	Professional		$25.12	$42.66	$57.54
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.55 / $13.18	Professional	26	$7.59	$9.55	$13.18
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $33.11 / $44.67	Professional	TC	$17.38	$33.11	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $72.44	Professional		$30.90	$39.81	$72.44
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 $27.54 / $35.48 / $61.66	Professional	TC	$27.54	$35.48	$61.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $363.08 / $363.08	Facility		$208.93	$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 $154.88 / $154.88 / $154.88	Facility	TC	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $275.42 / $275.42	Professional		$208.93	$275.42	$275.42
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Professional	26	$83.18	$83.18	$83.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $208.93 / $208.93	Professional	TC	$177.83	$208.93	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $32.36 / $37.15	Professional		$10.00	$32.36	$37.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $44.67 / $83.18	Facility		$29.51	$44.67	$83.18
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 $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $81.28	Professional		$26.92	$41.69	$81.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.23 / $19.95	Professional	26	$7.41	$10.23	$19.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $27.54 / $52.48	Professional	TC	$19.05	$27.54	$52.48
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
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 $75.86 / $75.86 / $75.86	Professional	TC	$75.86	$75.86	$75.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $47.86 / $64.57	Professional		$34.67	$47.86	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $138.04 / $218.78	Facility		$22.91	$138.04	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $31.62 / $67.61	Professional		$22.91	$31.62	$67.61
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 $16.60 / $22.91 / $48.98	Professional	TC	$16.60	$22.91	$48.98