Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $575.44 / $1,819.70	Facility		$104.71	$575.44	$1,819.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $47.86 / $165.96	Facility	26	$25.12	$47.86	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $467.74	Professional		$67.61	$104.71	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.88 / $141.25	Professional	26	$23.99	$33.88	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $77.62 / $218.78	Professional	TC	$43.65	$77.62	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $257.04	Professional		$81.28	$120.23	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $60.26	Professional	26	$23.99	$40.74	$60.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $27.54 / $645.65	Facility		$24.55	$27.54	$645.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $117.49 / $331.13	Professional		$70.79	$117.49	$331.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $40.74 / $89.13	Professional	26	$26.30	$40.74	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $74.13 / $251.19	Professional	TC	$44.67	$74.13	$251.19
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $128.82 / $436.52	Facility		$57.54	$128.82	$436.52
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $257.04	Professional		$69.18	$102.33	$257.04
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $37.15 / $79.43	Professional	26	$25.70	$37.15	$79.43
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $64.57 / $173.78	Professional	TC	$42.66	$64.57	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $186.21 / $6,165.95	Facility		$165.96	$186.21	$6,165.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $309.03	Professional		$79.43	$114.82	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $74.13	Professional	26	$23.44	$33.11	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $87.10 / $239.88	Professional	TC	$53.70	$87.10	$239.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $100.00 / $194.98	Professional		$66.07	$100.00	$194.98
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.84 / $38.02	Professional	26	$19.50	$28.84	$38.02
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $70.79 / $158.49	Professional	TC	$46.77	$70.79	$158.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $269.15	Professional		$131.83	$169.82	$269.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $39.81 / $70.79	Professional	26	$28.18	$39.81	$70.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $154.88 / $263.03	Professional	TC	$109.65	$154.88	$263.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $954.99 / $954.99	Professional		$758.58	$954.99	$954.99
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $213.80 / $213.80	Professional	26	$169.82	$213.80	$213.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $741.31 / $741.31	Professional	TC	$588.84	$741.31	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $83.18 / $131.83	Professional		$31.62	$83.18	$131.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $162.18 / $245.47	Facility		$95.50	$162.18	$245.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $316.23	Professional		$79.43	$123.03	$316.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $74.13	Professional	26	$23.44	$33.11	$74.13
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $85.11 / $239.88	Professional	TC	$51.29	$85.11	$239.88
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	26	$91.20	$91.20	$91.20
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $269.15 / $269.15	Professional	TC	$269.15	$269.15	$269.15
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $112.20 / $151.36	Professional		$66.07	$112.20	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $316.23	Professional		$54.95	$109.65	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $28.18 / $74.13	Professional	26	$18.62	$28.18	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $81.28 / $229.09	Professional	TC	$35.48	$81.28	$229.09