Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.34 / $351.61 / $840.14	Facility		$58.34	$351.61	$840.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.63 / $9.25 / $49.25	Facility	26	$7.63	$9.25	$49.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.09 / $135.38 / $524.33	Facility	TC	$25.09	$135.38	$524.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.46 / $39.00 / $125.00	Professional		$22.46	$39.00	$125.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $10.89 / $44.56	Professional	26	$7.43	$10.89	$44.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $24.20 / $72.88	Professional	TC	$18.82	$24.20	$72.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $35.96 / $69.47	Professional		$26.39	$35.96	$69.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $8.72 / $17.18	Professional	26	$5.98	$8.72	$17.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.98 / $50.44 / $50.44	Professional	TC	$22.98	$50.44	$50.44
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 $29.25 / $38.02 / $75.90	Professional		$29.25	$38.02	$75.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $11.39 / $22.20	Professional	26	$8.61	$11.39	$22.20
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 $27.95 / $35.81 / $87.85	Professional		$27.95	$35.81	$87.85
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.86 / $23.50	Professional	26	$7.75	$9.86	$23.50
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $25.95 / $60.04	Professional	TC	$20.57	$25.95	$60.04
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 $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
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 $26.55 / $39.56 / $83.10	Professional		$26.55	$39.56	$83.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $10.42 / $22.48	Professional	26	$7.40	$10.42	$22.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $28.81 / $66.63	Professional	TC	$19.14	$28.81	$66.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $41.72 / $56.32	Professional		$20.78	$41.72	$56.32
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $8.52 / $11.52	Professional	26	$5.82	$8.52	$11.52
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.96 / $33.19 / $44.81	Professional	TC	$14.96	$33.19	$44.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.57 / $41.35 / $67.25	Professional		$30.57	$41.35	$67.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $10.24 / $16.19	Professional	26	$7.55	$10.24	$16.19
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 $102.11 / $359.91 / $359.91	Facility		$102.11	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$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 $204.50 / $204.50 / $270.00	Professional		$204.50	$204.50	$270.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.30 / $74.30 / $74.30	Professional	26	$74.30	$74.30	$74.30
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 $26.88 / $32.34 / $32.34	Professional		$26.88	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.93 / $43.37 / $81.36	Facility		$28.93	$43.37	$81.36
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
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 $27.01 / $43.10 / $85.36	Professional		$27.01	$43.10	$85.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $10.17 / $22.48	Professional	26	$7.42	$10.17	$22.48
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $28.49 / $61.72	Professional	TC	$19.48	$28.49	$61.72
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $103.87 / $103.87	Professional		$103.87	$103.87	$103.87
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $27.49 / $27.49 / $27.49	Professional	26	$27.49	$27.49	$27.49
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $76.38 / $76.38 / $76.38	Professional	TC	$76.38	$76.38	$76.38
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $41.73 / $50.67	Professional		$31.17	$41.73	$50.67
United Facility/Professional Facility Modifier Low / Median / High Price $36.75 / $144.90 / $144.90	Facility		$36.75	$144.90	$144.90
United Facility/Professional Professional Modifier Low / Median / High Price $22.74 / $32.56 / $79.47	Professional		$22.74	$32.56	$79.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.06 / $21.05	Professional	26	$6.64	$9.06	$21.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $23.23 / $57.64	Professional	TC	$16.48	$23.23	$57.64