Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $55.39 / $179.32	Facility		$12.88	$55.39	$179.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.83 / $9.36 / $47.81	Facility	26	$8.83	$9.36	$47.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.26 / $13.36 / $39.04	Professional		$11.26	$13.36	$39.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $9.01 / $36.08	Professional	26	$7.86	$9.01	$36.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $12.27 / $12.27	Professional	50	$11.36	$12.27	$12.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.70 / $4.44 / $10.89	Professional	TC	$3.70	$4.44	$10.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $39.00 / $39.00	Professional	26	$39.00	$39.00	$39.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.47 / $203.00 / $706.00	Facility		$4.47	$203.00	$706.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.76 / $17.39 / $34.29	Professional		$12.76	$17.39	$34.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $12.39 / $23.16	Professional	26	$8.69	$12.39	$23.16
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $14.42 / $18.55 / $24.22	Professional	50	$14.42	$18.55	$24.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.34 / $4.90 / $10.61	Professional	TC	$3.34	$4.90	$10.61
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $9.41 / $23.12 / $43.52	Facility		$9.41	$23.12	$43.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $10.76 / $13.89 / $37.94	Professional		$10.76	$13.89	$37.94
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $11.12 / $29.06	Professional	26	$8.80	$11.12	$29.06
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $1.95 / $2.63 / $7.62	Professional	TC	$1.95	$2.63	$7.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8.17 / $69.39 / $145.09	Facility		$8.17	$69.39	$145.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.76 / $8.76 / $8.76	Facility	26	$8.76	$8.76	$8.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.17 / $16.52 / $34.82	Professional		$11.17	$16.52	$34.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $11.37 / $24.16	Professional	26	$7.85	$11.37	$24.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.13 / $5.36 / $12.35	Professional	TC	$3.13	$5.36	$12.35
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $10.11 / $13.48 / $18.20	Professional		$10.11	$13.48	$18.20
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $8.74 / $11.80	Professional	26	$6.48	$8.74	$11.80
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.64 / $4.73 / $6.39	Professional	TC	$3.64	$4.73	$6.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.78 / $14.15 / $23.15	Professional		$10.78	$14.15	$23.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.60 / $10.83 / $18.22	Professional	26	$7.60	$10.83	$18.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $3.92 / $5.65 / $9.41	Professional	TC	$3.92	$5.65	$9.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $25.79 / $80.00 / $109.11	Facility		$25.79	$80.00	$109.11
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.60 / $100.00 / $100.00	Facility	26	$17.60	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,428.44 / $1,428.44 / $1,428.44	Professional		$1,428.44	$1,428.44	$1,428.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,274.28 / $1,274.28 / $1,274.28	Professional	26	$1,274.28	$1,274.28	$1,274.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $988.10 / $988.10 / $988.10	Professional	TC	$988.10	$988.10	$988.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.10 / $32.34 / $32.34	Professional		$9.10	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $11.32 / $16.05 / $34.34	Facility		$11.32	$16.05	$34.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.76 / $8.76 / $8.76	Facility	26	$8.76	$8.76	$8.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $17.64 / $33.81	Professional		$11.89	$17.64	$33.81
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $11.25 / $23.97	Professional	26	$7.85	$11.25	$23.97
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $4.91 / $11.89	Professional	TC	$3.09	$4.91	$11.89
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $39.04 / $39.04	Professional		$39.04	$39.04	$39.04
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.39 / $26.39 / $26.39	Professional	26	$26.39	$26.39	$26.39
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $12.66 / $12.66 / $12.66	Professional	TC	$12.66	$12.66	$12.66
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $10.89 / $14.17 / $17.21	Professional		$10.89	$14.17	$17.21
United Facility/Professional Facility Modifier Low / Median / High Price $38.94 / $40.38 / $62.08	Facility		$38.94	$40.38	$62.08
United Facility/Professional Professional Modifier Low / Median / High Price $9.10 / $13.29 / $34.82	Professional		$9.10	$13.29	$34.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.54 / $8.74 / $21.74	Professional	26	$6.54	$8.74	$21.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.61 / $3.98 / $12.11	Professional	TC	$2.61	$3.98	$12.11