Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $402.46 / $945.44	Facility		$91.54	$402.46	$945.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $9.50 / $51.19	Facility	26	$7.78	$9.50	$51.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.90 / $261.30 / $562.57	Facility	TC	$32.90	$261.30	$562.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $44.74 / $156.00	Professional		$18.19	$44.74	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $11.94 / $44.75	Professional	26	$7.33	$11.94	$44.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.14 / $79.14 / $315.00	Professional	50	$79.14	$79.14	$315.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $30.57 / $98.12	Professional	TC	$23.28	$30.57	$98.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $35.10 / $72.56	Professional		$26.94	$35.10	$72.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $9.52 / $17.18	Professional	26	$6.16	$9.52	$17.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.75 / $45.23 / $50.44	Professional	TC	$25.75	$45.23	$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 $30.79 / $42.44 / $84.59	Professional		$30.79	$42.44	$84.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $11.39 / $22.20	Professional	26	$9.00	$11.39	$22.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.22 / $46.18 / $69.00	Professional	50	$40.22	$46.18	$69.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.54 / $31.52 / $61.71	Professional	TC	$21.54	$31.52	$61.71
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 $29.90 / $39.26 / $98.28	Professional		$29.90	$39.26	$98.28
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.27 / $23.67	Professional	26	$8.07	$10.27	$23.67
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $28.22 / $72.65	Professional	TC	$22.40	$28.22	$72.65
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 $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $42.69 / $89.99	Professional		$28.45	$42.69	$89.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $10.60 / $23.42	Professional	26	$7.54	$10.60	$23.42
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.75 / $38.75 / $43.94	Professional	50	$38.75	$38.75	$43.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.52 / $31.33 / $67.63	Professional	TC	$20.52	$31.33	$67.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $42.53 / $57.42	Professional		$25.98	$42.53	$57.42
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $9.34 / $12.61	Professional	26	$7.01	$9.34	$12.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $33.19 / $44.81	Professional	TC	$18.97	$33.19	$44.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $42.19 / $71.18	Professional		$31.19	$42.19	$71.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.21 / $17.73	Professional	26	$8.23	$11.21	$17.73
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 $109.65 / $359.91 / $359.91	Facility		$109.65	$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 $208.83 / $208.83 / $275.39	Professional		$208.83	$208.83	$275.39
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 $26.89 / $32.34 / $32.34	Professional		$26.89	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.61 / $44.85 / $84.09	Facility		$30.61	$44.85	$84.09
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $46.84 / $90.16	Professional		$29.62	$46.84	$90.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $10.39 / $22.87	Professional	26	$7.54	$10.39	$22.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.52 / $31.17 / $66.55	Professional	TC	$20.52	$31.17	$66.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $102.62 / $102.62 / $102.62	Professional		$102.62	$102.62	$102.62
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $28.64 / $28.64	Professional	26	$28.64	$28.64	$28.64
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $73.97 / $73.97 / $73.97	Professional	TC	$73.97	$73.97	$73.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.39 / $47.29 / $63.34	Professional		$34.39	$47.29	$63.34
United Facility/Professional Facility Modifier Low / Median / High Price $37.90 / $173.25 / $173.25	Facility		$37.90	$173.25	$173.25
United Facility/Professional Professional Modifier Low / Median / High Price $25.44 / $34.54 / $78.48	Professional		$25.44	$34.54	$78.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.65 / $22.25	Professional	26	$6.64	$9.65	$22.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.04 / $26.19 / $57.55	Professional	TC	$19.04	$26.19	$57.55