Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $426.58 / $933.25	Facility		$77.62	$426.58	$933.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.00 / $24.55	Facility	26	$7.94	$10.00	$24.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $165.96 / $501.19	Facility	TC	$33.11	$165.96	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $44.67 / $154.88	Professional		$12.88	$44.67	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.79 / $45.71	Professional	26	$7.76	$14.79	$45.71
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 $21.88 / $40.74 / $120.23	Professional	TC	$21.88	$40.74	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $70.79	Professional		$25.70	$34.67	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.49 / $19.50	Professional	26	$7.76	$13.49	$19.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $38.90 / $40.74	Professional	50	$38.90	$38.90	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $26.92 / $51.29	Professional	TC	$16.22	$26.92	$51.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $10.72 / $177.83	Facility		$9.55	$10.72	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $87.10	Professional		$33.11	$45.71	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $23.99	Professional	26	$9.12	$12.30	$23.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $47.86 / $75.86	Professional	50	$39.81	$47.86	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.11 / $63.10	Professional	TC	$23.99	$33.11	$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 $34.67 / $48.98 / $95.50	Professional		$34.67	$48.98	$95.50
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $22.39	Professional	26	$9.12	$12.02	$22.39
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $36.31 / $72.44	Professional	TC	$25.12	$36.31	$72.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $199.53 / $524.81	Facility		$50.12	$199.53	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $81.28	Professional		$28.18	$42.66	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.72 / $21.38	Professional	26	$7.41	$10.72	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $61.66	Professional	TC	$20.42	$31.62	$61.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $44.67 / $60.26	Professional		$25.70	$44.67	$60.26
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.55 / $13.18	Professional	26	$7.08	$9.55	$13.18
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $34.67 / $46.77	Professional	TC	$19.05	$34.67	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $74.13	Professional		$32.36	$41.69	$74.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $18.20	Professional	26	$8.32	$11.22	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $37.15 / $64.57	Professional	TC	$28.84	$37.15	$64.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $363.08 / $363.08	Facility		$208.93	$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 $154.88 / $154.88 / $154.88	Facility	TC	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $275.42 / $275.42	Professional		$48.98	$275.42	$275.42
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $208.93 / $208.93	Professional	TC	$177.83	$208.93	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $32.36 / $37.15	Professional		$10.00	$32.36	$37.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $45.71 / $85.11	Facility		$30.90	$45.71	$85.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $83.18	Professional		$28.18	$44.67	$83.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.23 / $20.42	Professional	26	$7.41	$10.23	$20.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $58.88	Professional	TC	$19.95	$30.20	$58.88
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	26	$28.84	$28.84	$28.84
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	TC	$74.13	$74.13	$74.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $48.98 / $63.10	Professional		$36.31	$48.98	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $138.04 / $218.78	Facility		$25.12	$138.04	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $69.18	Professional		$25.12	$33.11	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $18.20	Professional	26	$6.46	$9.12	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.99 / $50.12	Professional	TC	$18.62	$23.99	$50.12