Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.31 / $362.94 / $912.88	Facility		$49.31	$362.94	$912.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.48 / $9.13 / $49.25	Facility	26	$7.48	$9.13	$49.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.25 / $139.30 / $454.26	Facility	TC	$24.25	$139.30	$454.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.87 / $37.36 / $129.00	Professional		$17.87	$37.36	$129.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $11.10 / $44.00	Professional	26	$7.03	$11.10	$44.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.81 / $55.81 / $55.81	Professional	50	$55.81	$55.81	$55.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $25.67 / $83.34	Professional	TC	$18.21	$25.67	$83.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.46 / $41.42 / $64.98	Professional		$24.46	$41.42	$64.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.22 / $14.62	Professional	26	$5.67	$8.22	$14.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.90 / $25.58 / $26.03	Professional	TC	$22.90	$25.58	$26.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.75 / $169.00 / $876.00	Facility		$8.75	$169.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.05 / $35.59 / $70.00	Professional		$27.05	$35.59	$70.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $10.41 / $20.11	Professional	26	$8.31	$10.41	$20.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.11 / $41.41 / $59.74	Professional	50	$36.11	$41.41	$59.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.04 / $25.34 / $50.04	Professional	TC	$19.04	$25.34	$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 $24.51 / $31.76 / $80.48	Professional		$24.51	$31.76	$80.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.86 / $22.76	Professional	26	$7.75	$9.86	$22.76
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $17.29 / $21.90 / $58.08	Professional	TC	$17.29	$21.90	$58.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.77 / $225.99 / $483.01	Facility		$44.77	$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 $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.41 / $36.54 / $76.34	Professional		$24.41	$36.54	$76.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $9.90 / $22.27	Professional	26	$7.06	$9.90	$22.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.49 / $36.49 / $41.33	Professional	50	$36.49	$36.49	$41.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $26.31 / $60.05	Professional	TC	$17.37	$26.31	$60.05
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 $6.44 / $8.52 / $11.52	Professional	26	$6.44	$8.52	$11.52
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.34 / $29.52 / $39.85	Professional	TC	$14.34	$29.52	$39.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $37.79 / $62.78	Professional		$27.94	$37.79	$62.78
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 $23.62 / $34.22 / $55.45	Professional	TC	$23.62	$34.22	$55.45
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $92.12 / $359.91 / $359.91	Facility		$92.12	$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 / $118.47 / $118.47	Facility	TC	$100.00	$118.47	$118.47
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 $64.39 / $64.39 / $64.39	Professional	26	$64.39	$64.39	$64.39
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.00 / $161.00 / $185.03	Professional	TC	$161.00	$161.00	$185.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $32.34 / $32.34	Professional		$23.95	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.47 / $39.47 / $74.73	Facility		$26.47	$39.47	$74.73
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 $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $39.94 / $78.17	Professional		$24.98	$39.94	$78.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $9.69 / $20.90	Professional	26	$7.06	$9.69	$20.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.47 / $25.82 / $56.75	Professional	TC	$17.47	$25.82	$56.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $95.46 / $95.46 / $95.46	Professional		$95.46	$95.46	$95.46
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 $67.95 / $67.95 / $67.95	Professional	TC	$67.95	$67.95	$67.95
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 / $144.90 / $144.90	Facility		$33.69	$144.90	$144.90
United Facility/Professional Professional Modifier Low / Median / High Price $20.74 / $29.51 / $87.90	Professional		$20.74	$29.51	$87.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $8.92 / $21.36	Professional	26	$6.08	$8.92	$21.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.05 / $20.57 / $51.29	Professional	TC	$15.05	$20.57	$51.29