Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $28.84 / $147.91	Facility		$10.23	$28.84	$147.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $16.98 / $48.98	Facility	26	$7.94	$16.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $13.80 / $38.90	Professional		$10.72	$13.80	$38.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $36.31	Professional	26	$7.08	$9.33	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $12.30 / $29.51	Professional	50	$11.48	$12.30	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $4.47 / $14.45	Professional	TC	$3.02	$4.47	$14.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $9.77 / $26.92	Professional		$7.94	$9.77	$26.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $15.85 / $15.85	Professional	26	$15.85	$15.85	$15.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.47 / $4.90 / $61.66	Facility		$4.47	$4.90	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $17.38 / $33.11	Professional		$12.88	$17.38	$33.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.88 / $22.91	Professional	26	$9.33	$12.88	$22.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $14.45 / $19.05 / $39.81	Professional	50	$14.45	$19.05	$39.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.24 / $4.57 / $10.47	Professional	TC	$3.24	$4.57	$10.47
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $24.55 / $57.54	Facility		$8.32	$24.55	$57.54
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $16.98 / $33.11	Professional		$12.02	$16.98	$33.11
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.80 / $26.30	Professional	26	$9.77	$13.80	$26.30
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $2.14 / $3.24 / $7.59	Professional	TC	$2.14	$3.24	$7.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7.41 / $54.95 / $154.88	Facility		$7.41	$54.95	$154.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.30	Facility	26	$1.86	$8.71	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $16.22 / $30.20	Professional		$10.72	$16.22	$30.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.48 / $21.38	Professional	26	$7.08	$11.48	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $5.01 / $10.72	Professional	TC	$3.09	$5.01	$10.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.45 / $19.50	Professional		$10.00	$14.45	$19.50
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $12.30	Professional	26	$6.46	$9.12	$12.30
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.63 / $5.37 / $7.24	Professional	TC	$3.63	$5.37	$7.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.13 / $22.91	Professional		$10.96	$14.13	$22.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $16.60	Professional	26	$7.94	$10.72	$16.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $4.17 / $6.03 / $10.23	Professional	TC	$4.17	$6.03	$10.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
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 Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional	26	$1,288.25	$1,288.25	$1,288.25
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $977.24 / $977.24 / $977.24	Professional	TC	$977.24	$977.24	$977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $9.12 / $13.18	Professional		$3.47	$9.12	$13.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $16.98 / $34.67	Facility		$11.22	$16.98	$34.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.30	Facility	26	$1.86	$8.71	$12.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $16.98 / $30.90	Professional		$10.72	$16.98	$30.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $20.42	Professional	26	$7.08	$10.96	$20.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $4.79 / $10.96	Professional	TC	$3.02	$4.79	$10.96
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Professional	26	$26.30	$26.30	$26.30
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $12.59 / $12.59	Professional	TC	$12.59	$12.59	$12.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $13.18 / $17.38	Professional		$10.00	$13.18	$17.38
United Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $47.86 / $72.44	Facility		$45.71	$47.86	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $12.30 / $25.70	Professional		$9.12	$12.30	$25.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.32 / $17.78	Professional	26	$6.61	$8.32	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.57 / $3.98 / $8.91	Professional	TC	$2.57	$3.98	$8.91