Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.85 / $322.12 / $727.94	Facility		$41.85	$322.12	$727.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.18 / $8.32 / $49.25	Facility	26	$7.18	$8.32	$49.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.48 / $101.33 / $428.22	Facility	TC	$24.48	$101.33	$428.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $38.72 / $124.00	Professional		$23.30	$38.72	$124.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $10.96 / $39.64	Professional	26	$6.74	$10.96	$39.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.00 / $171.72 / $171.72	Professional	50	$30.00	$171.72	$171.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $22.54 / $63.83	Professional	TC	$18.39	$22.54	$63.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $29.58 / $64.98	Professional		$21.93	$29.58	$64.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $8.56 / $18.22	Professional	26	$5.90	$8.56	$18.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $25.19 / $25.19	Professional	TC	$25.19	$25.19	$25.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.35 / $169.00 / $876.00	Facility		$8.35	$169.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $34.95 / $69.11	Professional		$26.56	$34.95	$69.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $9.97 / $19.21	Professional	26	$7.93	$9.97	$19.21
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.11 / $39.84 / $59.74	Professional	50	$36.11	$39.84	$59.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $25.49 / $50.04	Professional	TC	$18.88	$25.49	$50.04
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $95.60 / $209.05	Facility		$53.00	$95.60	$209.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $26.05 / $33.63 / $84.84	Professional		$26.05	$33.63	$84.84
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $9.47 / $21.84	Professional	26	$7.44	$9.47	$21.84
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $24.11 / $60.04	Professional	TC	$19.12	$24.11	$60.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.07 / $225.99 / $483.01	Facility		$44.07	$225.99	$483.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.80 / $36.59 / $77.65	Professional		$24.80	$36.59	$77.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $9.73 / $21.55	Professional	26	$6.95	$9.73	$21.55
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.11 / $35.11 / $39.76	Professional	50	$35.11	$35.11	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.53 / $26.65 / $59.10	Professional	TC	$17.53	$26.65	$59.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $38.04 / $51.37	Professional		$20.78	$38.04	$51.37
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $8.99 / $12.14	Professional	26	$5.82	$8.99	$12.14
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.96 / $29.06 / $39.22	Professional	TC	$14.96	$29.06	$39.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $37.79 / $63.78	Professional		$27.94	$37.79	$63.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $10.79 / $17.07	Professional	26	$7.90	$10.79	$17.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.25 / $33.68 / $54.60	Professional	TC	$23.25	$33.68	$54.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $88.21 / $359.91 / $359.91	Facility		$88.21	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $116.61 / $116.61	Facility	TC	$100.00	$116.61	$116.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $187.12 / $187.12 / $247.35	Professional		$187.12	$187.12	$247.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $67.70 / $67.70	Professional	26	$67.70	$67.70	$67.70
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.00 / $160.00 / $182.25	Professional	TC	$160.00	$160.00	$182.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $32.34 / $32.34	Professional		$23.58	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.47 / $39.74 / $74.73	Facility		$26.47	$39.74	$74.73
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $40.02 / $78.17	Professional		$25.15	$40.02	$78.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $9.51 / $21.20	Professional	26	$7.06	$9.51	$21.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.53 / $26.55 / $57.12	Professional	TC	$17.53	$26.55	$57.12
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $94.25 / $94.25	Professional		$94.25	$94.25	$94.25
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 $66.76 / $66.76 / $66.76	Professional	TC	$66.76	$66.76	$66.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.77 / $41.73 / $50.67	Professional		$30.77	$41.73	$50.67
United Facility/Professional Facility Modifier Low / Median / High Price $33.69 / $133.88 / $133.88	Facility		$33.69	$133.88	$133.88
United Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $29.60 / $72.04	Professional		$20.46	$29.60	$72.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.81 / $8.66 / $20.48	Professional	26	$5.81	$8.66	$20.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.06 / $21.44 / $51.56	Professional	TC	$15.06	$21.44	$51.56