Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.07 / $202.07 / $202.07	Facility		$202.07	$202.07	$202.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.48 / $20.00 / $47.73	Professional		$14.48	$20.00	$47.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $12.92 / $47.94	Professional	26	$9.09	$12.92	$47.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.81 / $7.41 / $19.18	Professional	TC	$5.81	$7.41	$19.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $10.07 / $10.07 / $19.85	Professional		$10.07	$10.07	$19.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $19.72 / $27.49	Professional	26	$5.80	$19.72	$27.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $4.12 / $4.12 / $4.12	Professional	TC	$4.12	$4.12	$4.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $22.58 / $51.38	Professional		$17.37	$22.58	$51.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $15.34 / $32.24	Professional	26	$11.37	$15.34	$32.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.18 / $7.44 / $21.31	Professional	TC	$4.18	$7.44	$21.31
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $15.53 / $21.31 / $56.80	Professional		$15.53	$21.31	$56.80
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $15.10 / $43.30	Professional	26	$10.67	$15.10	$43.30
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $4.79 / $6.21 / $17.66	Professional	TC	$4.79	$6.21	$17.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.98 / $18.98 / $18.98	Facility		$18.98	$18.98	$18.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.74 / $12.78 / $42.43	Professional		$9.74	$12.78	$42.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.13 / $7.58 / $25.45	Professional	26	$6.13	$7.58	$25.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.57 / $5.22 / $18.00	Professional	TC	$3.57	$5.22	$18.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $7.90 / $24.80 / $33.47	Professional		$7.90	$24.80	$33.47
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $13.64 / $18.41	Professional	26	$6.32	$13.64	$18.41
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.58 / $11.16 / $15.07	Professional	TC	$1.58	$11.16	$15.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $23.94 / $38.44	Professional		$19.32	$23.94	$38.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $16.37 / $20.48	Professional	26	$10.91	$16.37	$20.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $8.26 / $13.39 / $16.73	Professional	TC	$8.26	$13.39	$16.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $45.64 / $100.00 / $104.74	Facility		$45.64	$100.00	$104.74
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $28.22 / $100.00 / $100.00	Facility	26	$28.22	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $15.62 / $100.00 / $100.00	Facility	TC	$15.62	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $130.47 / $130.47 / $169.05	Professional		$130.47	$130.47	$169.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.76 / $95.76 / $97.13	Professional	26	$95.76	$95.76	$97.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.76 / $95.76 / $95.76	Professional	TC	$95.76	$95.76	$95.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $14.27 / $23.55	Professional		$9.27	$14.27	$23.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $18.55 / $26.46 / $35.72	Facility		$18.55	$26.46	$35.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $9.91 / $22.21 / $57.95	Professional		$9.91	$22.21	$57.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.13 / $7.87 / $31.32	Professional	26	$6.13	$7.87	$31.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.57 / $5.64 / $18.50	Professional	TC	$3.57	$5.64	$18.50
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $80.66 / $80.66 / $80.66	Professional		$80.66	$80.66	$80.66
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $47.16 / $47.16 / $47.16	Professional	26	$47.16	$47.16	$47.16
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $33.50 / $33.50	Professional	TC	$33.50	$33.50	$33.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $20.05 / $27.57	Professional		$20.05	$20.05	$27.57
United Facility/Professional Facility Modifier Low / Median / High Price $16.80 / $16.80 / $16.80	Facility		$16.80	$16.80	$16.80
United Facility/Professional Professional Modifier Low / Median / High Price $11.06 / $13.74 / $48.80	Professional		$11.06	$13.74	$48.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.15 / $7.95 / $27.82	Professional	26	$7.15	$7.95	$27.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.76 / $5.78 / $25.65	Professional	TC	$3.76	$5.78	$25.65