Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $309.03 / $707.95	Facility		$51.29	$309.03	$707.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $9.12 / $22.39	Facility	26	$7.08	$9.12	$22.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $97.72 / $416.87	Facility	TC	$26.30	$97.72	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $39.81 / $123.03	Professional		$16.98	$39.81	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.49 / $39.81	Professional	26	$7.08	$13.49	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $79.43 / $158.49	Professional	50	$42.66	$79.43	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.18 / $100.00	Professional	TC	$17.78	$28.18	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.90 / $64.57	Professional		$21.88	$30.90	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $13.49 / $19.05	Professional	26	$6.61	$13.49	$19.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $17.38 / $38.90	Professional	TC	$14.79	$17.38	$38.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $9.33 / $154.88	Facility		$8.32	$9.33	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.90 / $75.86	Professional		$28.18	$38.90	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $21.38	Professional	26	$7.94	$10.72	$21.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $41.69 / $63.10	Professional	50	$35.48	$41.69	$63.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $54.95	Professional	TC	$20.42	$28.18	$54.95
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $102.33 / $239.88	Facility		$54.95	$102.33	$239.88
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $81.28	Professional		$30.20	$40.74	$81.28
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $20.42	Professional	26	$8.51	$11.22	$20.42
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $60.26	Professional	TC	$21.38	$30.20	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $199.53 / $524.81	Facility		$43.65	$199.53	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.95 / $9.12 / $13.18	Facility	26	$1.95	$9.12	$13.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.11	Facility	TC	$5.01	$23.44	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $69.18	Professional		$25.12	$37.15	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.00 / $19.95	Professional	26	$6.92	$10.00	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.30 / $52.48	Professional	TC	$17.38	$26.30	$52.48
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.90 / $52.48	Professional		$20.89	$38.90	$52.48
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $9.33 / $12.59	Professional	26	$5.75	$9.33	$12.59
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $29.51 / $39.81	Professional	TC	$14.79	$29.51	$39.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $64.57	Professional		$28.84	$37.15	$64.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $17.38	Professional	26	$7.94	$10.72	$17.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $32.36 / $56.23	Professional	TC	$24.55	$32.36	$56.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $363.08 / $363.08	Facility		$186.21	$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 $134.90 / $134.90 / $134.90	Facility	TC	$134.90	$134.90	$134.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $245.47 / $245.47	Professional		$186.21	$245.47	$245.47
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	26	$67.61	$67.61	$67.61
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $181.97 / $181.97	Professional	TC	$158.49	$181.97	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $32.36 / $33.11	Professional		$9.55	$32.36	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $40.74 / $77.62	Facility		$26.92	$40.74	$77.62
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $1.95 / $9.12 / $13.18	Facility	26	$1.95	$9.12	$13.18
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.11	Facility	TC	$5.01	$23.44	$33.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $74.13	Professional		$25.12	$38.02	$74.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.33 / $18.62	Professional	26	$6.92	$9.33	$18.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $50.12	Professional	TC	$17.38	$25.70	$50.12
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 $27.54 / $27.54 / $27.54	Professional	26	$27.54	$27.54	$27.54
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 $30.90 / $38.90 / $50.12	Professional		$30.90	$38.90	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $138.04 / $218.78	Facility		$19.95	$138.04	$218.78
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 $5.75 / $8.71 / $17.38	Professional	26	$5.75	$8.71	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.42 / $44.67	Professional	TC	$15.14	$20.42	$44.67