Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $389.05 / $954.99	Facility		$60.26	$389.05	$954.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $11.48 / $26.30	Facility	26	$8.91	$11.48	$26.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $162.18 / $616.60	Facility	TC	$28.84	$162.18	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $43.65 / $141.25	Professional		$13.49	$43.65	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.45 / $51.29	Professional	26	$8.51	$14.45	$51.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $79.43 / $190.55	Professional	50	$30.20	$79.43	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.90 / $107.15	Professional	TC	$19.95	$38.90	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $36.31 / $75.86	Professional		$27.54	$36.31	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.22 / $21.88	Professional	26	$7.24	$11.22	$21.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $42.66 / $66.07	Professional	50	$35.48	$42.66	$66.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.92 / $53.70	Professional	TC	$18.20	$26.92	$53.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $11.75 / $190.55	Facility		$10.72	$11.75	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $43.65 / $85.11	Professional		$30.90	$43.65	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.49 / $26.30	Professional	26	$9.77	$13.49	$26.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $50.12 / $77.62	Professional	50	$40.74	$50.12	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.90 / $63.10	Professional	TC	$21.38	$30.90	$63.10
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $112.20 / $263.03	Facility		$57.54	$112.20	$263.03
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $89.13	Professional		$32.36	$44.67	$89.13
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.80 / $25.12	Professional	26	$10.47	$13.80	$25.12
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 $53.70 / $199.53 / $524.81	Facility		$53.70	$199.53	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $79.43	Professional		$27.54	$40.74	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.75 / $22.91	Professional	26	$8.13	$11.75	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $28.84 / $58.88	Professional	TC	$19.50	$28.84	$58.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $47.86 / $64.57	Professional		$25.70	$47.86	$64.57
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $14.13	Professional	26	$7.94	$10.47	$14.13
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $37.15 / $50.12	Professional	TC	$17.78	$37.15	$50.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $77.62	Professional		$34.67	$44.67	$77.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $19.50	Professional	26	$9.12	$12.02	$19.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $39.81 / $70.79	Professional	TC	$30.90	$39.81	$70.79
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $363.08 / $363.08	Facility		$223.87	$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 $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $295.12 / $295.12	Professional		$51.29	$295.12	$295.12
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	26	$89.13	$89.13	$89.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $218.78 / $218.78	Professional	TC	$177.83	$218.78	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $38.90	Professional		$10.72	$32.36	$38.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $47.86 / $89.13	Facility		$30.90	$47.86	$89.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $87.10	Professional		$28.18	$42.66	$87.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $21.88	Professional	26	$7.94	$11.22	$21.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $27.54 / $54.95	Professional	TC	$19.05	$27.54	$54.95
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	26	$30.90	$30.90	$30.90
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	TC	$79.43	$79.43	$79.43
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $63.10	Professional		$38.90	$48.98	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $138.04 / $218.78	Facility		$30.20	$138.04	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $70.79	Professional		$22.91	$33.88	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.77 / $19.50	Professional	26	$7.08	$9.77	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $51.29	Professional	TC	$16.60	$23.99	$51.29