Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $271.38 / $271.38 / $271.38	Facility		$271.38	$271.38	$271.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.98 / $54.47 / $118.00	Professional		$29.98	$54.47	$118.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.40 / $7.12 / $31.84	Professional	26	$5.40	$7.12	$31.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $48.48 / $100.32	Professional	TC	$23.29	$48.48	$100.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $18.82 / $127.50	Professional		$16.12	$18.82	$127.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.21 / $11.62 / $32.97	Professional	26	$3.21	$11.62	$32.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.05 / $13.05 / $13.05	Professional	TC	$13.05	$13.05	$13.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.51 / $57.21 / $119.60	Professional		$23.51	$57.21	$119.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.13 / $9.93 / $22.84	Professional	26	$6.13	$9.93	$22.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $49.44 / $88.08	Professional	TC	$19.73	$49.44	$88.08
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $49.42 / $118.97	Professional		$35.65	$49.42	$118.97
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $18.00 / $37.04	Professional	26	$5.90	$18.00	$37.04
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.24 / $33.51 / $100.00	Professional	TC	$26.24	$33.51	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.47 / $61.47 / $61.47	Facility		$61.47	$61.47	$61.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $29.46 / $89.73	Professional		$16.55	$29.46	$89.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.41 / $4.26 / $14.91	Professional	26	$3.41	$4.26	$14.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.69 / $25.18 / $74.43	Professional	TC	$12.69	$25.18	$74.43
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.94 / $43.88 / $59.24	Professional		$20.94	$43.88	$59.24
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $10.08 / $16.75	Professional	26	$7.47	$10.08	$16.75
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.19 / $36.40 / $49.14	Professional	TC	$4.19	$36.40	$49.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.89 / $40.77 / $68.01	Professional		$33.89	$40.77	$68.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $8.96 / $11.22	Professional	26	$5.98	$8.96	$11.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $43.57 / $54.60	Professional	TC	$26.90	$43.57	$54.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.73 / $162.36 / $178.89	Facility		$80.73	$162.36	$178.89
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.48 / $100.00 / $100.00	Facility	26	$15.48	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.07 / $270.27 / $282.08	Professional		$263.07	$270.27	$282.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.30 / $145.30 / $145.30	Professional	26	$145.30	$145.30	$145.30
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.21 / $227.48 / $232.41	Professional	TC	$226.21	$227.48	$232.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.96 / $28.72 / $36.68	Professional		$7.96	$28.72	$36.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $37.65 / $54.00 / $76.59	Facility		$37.65	$54.00	$76.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $47.64 / $89.73	Professional		$17.14	$47.64	$89.73
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.48 / $4.49 / $20.03	Professional	26	$3.48	$4.49	$20.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.69 / $26.59 / $74.43	Professional	TC	$12.69	$26.59	$74.43
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $116.80 / $116.80 / $116.80	Professional		$116.80	$116.80	$116.80
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.93 / $25.93 / $25.93	Professional	26	$25.93	$25.93	$25.93
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $90.86 / $90.86 / $90.86	Professional	TC	$90.86	$90.86	$90.86
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $35.47 / $48.79	Professional		$35.47	$35.47	$48.79
United Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $84.00	Facility		$60.00	$60.00	$84.00
United Facility/Professional Professional Modifier Low / Median / High Price $18.84 / $29.42 / $75.91	Professional		$18.84	$29.42	$75.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.86 / $4.54 / $27.74	Professional	26	$3.86	$4.54	$27.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $24.18 / $69.78	Professional	TC	$14.51	$24.18	$69.78