Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $28.18 / $63.10	Professional		$12.88	$28.18	$63.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $4.57 / $17.38	Professional	26	$3.02	$4.57	$17.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $22.91 / $53.70	Professional	TC	$7.94	$22.91	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $16.22 / $29.51	Professional		$8.13	$16.22	$29.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.14 / $7.41 / $19.50	Professional	26	$2.14	$7.41	$19.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $25.70 / $61.66	Professional		$13.18	$25.70	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $7.94 / $16.22	Professional	26	$4.37	$7.94	$16.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $20.42 / $44.67	Professional	TC	$5.50	$20.42	$44.67
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $31.62 / $74.13	Professional		$22.91	$31.62	$74.13
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $31.62	Professional	26	$10.96	$14.13	$31.62
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $16.60 / $41.69	Professional	TC	$12.88	$16.60	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Facility		$29.51	$29.51	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $14.45 / $43.65	Professional		$8.13	$14.45	$43.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.24 / $2.57 / $8.32	Professional	26	$2.24	$2.57	$8.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.75 / $11.22 / $33.88	Professional	TC	$5.75	$11.22	$33.88
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $21.38 / $28.84	Professional		$8.32	$21.38	$28.84
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $6.61 / $6.76	Professional	26	$4.90	$6.61	$6.76
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.66 / $16.60 / $22.39	Professional	TC	$1.66	$16.60	$22.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $20.42 / $32.36	Professional		$16.60	$20.42	$32.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $5.75 / $7.41	Professional	26	$3.98	$5.75	$7.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $18.20 / $25.12	Professional	TC	$12.59	$18.20	$25.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $100.00	Facility		$95.50	$95.50	$100.00
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 $125.89 / $141.25 / $141.25	Professional		$125.89	$141.25	$141.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	26	$87.10	$87.10	$87.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $104.71 / $104.71	Professional	TC	$100.00	$104.71	$104.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $24.55 / $43.65	Facility		$12.59	$24.55	$43.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $16.60 / $47.86	Professional		$8.71	$16.60	$47.86
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $2.24 / $3.31 / $11.22	Professional	26	$2.24	$3.31	$11.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $6.17 / $11.75 / $35.48	Professional	TC	$6.17	$11.75	$35.48
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Professional	26	$16.60	$16.60	$16.60
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	TC	$41.69	$41.69	$41.69
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $17.78 / $23.99	Professional		$17.78	$17.78	$23.99
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $14.45 / $43.65	Professional		$9.55	$14.45	$43.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.57 / $2.88 / $11.22	Professional	26	$2.57	$2.88	$11.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $11.22 / $32.36	Professional	TC	$6.76	$11.22	$32.36