Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.52 / $399.04 / $958.80	Facility		$94.52	$399.04	$958.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $10.17 / $51.19	Facility	26	$8.13	$10.17	$51.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.84 / $267.24 / $571.94	Facility	TC	$35.84	$267.24	$571.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $52.96 / $191.64	Professional		$27.89	$52.96	$191.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $14.70 / $49.65	Professional	26	$7.64	$14.70	$49.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $73.70 / $340.50	Professional	50	$17.85	$73.70	$340.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $39.36 / $138.47	Professional	TC	$25.37	$39.36	$138.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $46.73 / $92.48	Professional		$34.08	$46.73	$92.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $9.52 / $18.69	Professional	26	$6.16	$9.52	$18.69
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $50.65 / $89.22 / $112.92	Professional	50	$50.65	$89.22	$112.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.39 / $61.46 / $68.55	Professional	TC	$37.39	$61.46	$68.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.57 / $212.13 / $876.00	Facility		$9.57	$212.13	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $43.99 / $87.11	Professional		$32.74	$43.99	$87.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $11.40 / $22.51	Professional	26	$9.00	$11.40	$22.51
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.19 / $53.02 / $77.09	Professional	50	$42.19	$53.02	$77.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $33.04 / $64.59	Professional	TC	$24.83	$33.04	$64.59
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $95.98 / $210.87	Facility		$53.00	$95.98	$210.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $43.99 / $100.00	Professional		$35.10	$43.99	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.27 / $24.33	Professional	26	$8.07	$10.27	$24.33
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.97 / $33.86 / $84.18	Professional	TC	$26.97	$33.86	$84.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.98 / $225.99 / $483.01	Facility		$67.98	$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 $36.90 / $36.90 / $36.90	Facility	TC	$36.90	$36.90	$36.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $46.23 / $103.08	Professional		$31.71	$46.23	$103.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $10.63 / $23.45	Professional	26	$7.54	$10.63	$23.45
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.36 / $47.36 / $53.88	Professional	50	$47.36	$47.36	$53.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $35.64 / $85.88	Professional	TC	$23.31	$35.64	$85.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.14 / $54.47 / $73.53	Professional		$25.14	$54.47	$73.53
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.34 / $12.61	Professional	26	$6.03	$9.34	$12.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $45.13 / $60.93	Professional	TC	$19.11	$45.13	$60.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $53.74 / $90.00	Professional		$39.72	$53.74	$90.00
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 $36.10 / $52.25 / $84.71	Professional	TC	$36.10	$52.25	$84.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $102.16 / $359.91 / $359.91	Facility		$102.16	$359.91	$359.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $100.00 / $100.00	Facility	26	$27.00	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $180.83 / $180.83	Facility	TC	$100.00	$180.83	$180.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.06 / $263.06 / $348.98	Professional		$263.06	$263.06	$348.98
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $67.70 / $67.73	Professional	26	$67.70	$67.70	$67.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.88 / $209.88 / $281.25	Professional	TC	$209.88	$209.88	$281.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $36.04	Professional		$32.34	$32.34	$36.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.88 / $51.77 / $98.72	Facility		$35.88	$51.77	$98.72
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 $36.90 / $36.90 / $36.90	Facility	TC	$36.90	$36.90	$36.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $52.17 / $109.62	Professional		$32.11	$52.17	$109.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $10.45 / $23.42	Professional	26	$7.54	$10.45	$23.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $34.60 / $82.29	Professional	TC	$23.31	$34.60	$82.29
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $129.07 / $129.07 / $129.07	Professional		$129.07	$129.07	$129.07
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 $100.42 / $100.42 / $100.42	Professional	TC	$100.42	$100.42	$100.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.70 / $50.48 / $61.29	Professional		$37.70	$50.48	$61.29
United Facility/Professional Facility Modifier Low / Median / High Price $47.47 / $173.25 / $173.25	Facility		$47.47	$173.25	$173.25
United Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $40.86 / $116.84	Professional		$25.72	$40.86	$116.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.43 / $25.79	Professional	26	$6.64	$9.43	$25.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $30.32 / $75.31	Professional	TC	$19.07	$30.32	$75.31