Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.89 / $374.00 / $907.36	Facility		$37.89	$374.00	$907.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.25 / $9.66 / $49.25	Facility	26	$8.25	$9.66	$49.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.11 / $112.85 / $392.48	Facility	TC	$26.11	$112.85	$392.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $42.15 / $154.37	Professional		$22.77	$42.15	$154.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $11.24 / $46.78	Professional	26	$7.66	$11.24	$46.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.88 / $52.88 / $279.00	Professional	50	$52.88	$52.88	$279.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.47 / $17.07 / $121.50	Professional	52	$11.47	$17.07	$121.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $25.64 / $99.00	Professional	TC	$20.07	$25.64	$99.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $34.11 / $59.90	Professional		$27.75	$34.11	$59.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $8.24 / $14.76	Professional	26	$5.90	$8.24	$14.76
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.33 / $72.33 / $72.33	Professional	50	$72.33	$72.33	$72.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.39 / $172.82 / $876.00	Facility		$9.39	$172.82	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $37.33 / $75.18	Professional		$28.43	$37.33	$75.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $10.90 / $21.00	Professional	26	$8.48	$10.90	$21.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.59 / $43.29 / $64.54	Professional	50	$37.59	$43.29	$64.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $26.54 / $55.06	Professional	TC	$20.74	$26.54	$55.06
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $51.68 / $94.98 / $199.44	Facility		$51.68	$94.98	$199.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $35.88 / $92.05	Professional		$28.62	$35.88	$92.05
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.86 / $23.33	Professional	26	$7.75	$9.86	$23.33
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $25.95 / $63.31	Professional	TC	$20.57	$25.95	$63.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.92 / $225.99 / $483.01	Facility		$53.92	$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 $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.08 / $39.97 / $90.42	Professional		$27.08	$39.97	$90.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $10.34 / $22.48	Professional	26	$7.20	$10.34	$22.48
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $47.09	Professional	50	$41.47	$41.47	$47.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $28.98 / $70.23	Professional	TC	$19.19	$28.98	$70.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $44.02 / $59.43	Professional		$17.30	$44.02	$59.43
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.84 / $8.99 / $12.14	Professional	26	$4.84	$8.99	$12.14
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.46 / $35.03 / $47.29	Professional	TC	$12.46	$35.03	$47.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $43.59 / $69.90	Professional		$32.22	$43.59	$69.90
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 $28.02 / $40.58 / $65.78	Professional	TC	$28.02	$40.58	$65.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $85.73 / $359.91 / $359.91	Facility		$85.73	$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 / $140.51 / $140.51	Facility	TC	$100.00	$140.51	$140.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $217.55 / $217.55 / $284.18	Professional		$217.55	$217.55	$284.18
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.45 / $59.45 / $65.18	Professional	26	$59.45	$59.45	$65.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $166.53 / $166.53 / $219.00	Professional	TC	$166.53	$166.53	$219.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.72 / $32.34 / $32.34	Professional		$28.72	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.48 / $43.05 / $83.40	Facility		$29.48	$43.05	$83.40
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 $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $44.87 / $90.75	Professional		$27.95	$44.87	$90.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.02 / $22.27	Professional	26	$7.25	$10.02	$22.27
Providence Facility/Professional Professional Modifier 52 Low / Median / High Price $37.28 / $37.28 / $39.11	Professional	52	$37.28	$37.28	$39.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $28.28 / $66.55	Professional	TC	$19.21	$28.28	$66.55
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $108.68 / $108.68 / $108.68	Professional		$108.68	$108.68	$108.68
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 $81.19 / $81.19 / $81.19	Professional	TC	$81.19	$81.19	$81.19
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $25.96 / $40.04 / $48.94	Professional		$25.96	$40.04	$48.94
United Facility/Professional Facility Modifier Low / Median / High Price $39.04 / $119.70 / $119.70	Facility		$39.04	$119.70	$119.70
United Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $33.20 / $83.19	Professional		$21.85	$33.20	$83.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.19 / $20.48	Professional	26	$6.64	$9.19	$20.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.34 / $24.54 / $61.78	Professional	TC	$15.34	$24.54	$61.78