Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.53 / $332.30 / $525.53	Facility		$88.53	$332.30	$525.53
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.02 / $24.47 / $128.24	Facility	26	$22.02	$24.47	$128.24
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $64.06 / $350.81 / $541.39	Facility	TC	$64.06	$350.81	$541.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $75.00 / $167.03	Professional		$39.43	$75.00	$167.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.55 / $24.51 / $92.53	Professional	26	$20.55	$24.51	$92.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.42 / $234.74 / $288.89	Professional	50	$85.42	$234.74	$288.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.48 / $34.75 / $120.52	Professional	52	$15.48	$34.75	$120.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $53.22 / $104.25	Professional	TC	$17.14	$53.22	$104.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $30.69 / $32.14	Professional		$30.69	$30.69	$32.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $100.64 / $100.64 / $100.64	Professional	26	$100.64	$100.64	$100.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,988.00 / $4,549.00 / $9,589.00	Facility		$1,988.00	$4,549.00	$9,589.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.54 / $69.54 / $136.21	Professional		$43.54	$69.54	$136.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $26.51 / $61.79	Professional	26	$20.38	$26.51	$61.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.28 / $68.68 / $104.31	Professional	50	$44.28	$68.68	$104.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.90 / $44.52 / $86.87	Professional	TC	$14.90	$44.52	$86.87
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $59.30 / $100.00 / $580.23	Facility		$59.30	$100.00	$580.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $61.42 / $79.11 / $171.55	Professional		$61.42	$79.11	$171.55
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $23.22 / $58.86	Professional	26	$17.51	$23.22	$58.86
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $42.78 / $55.87 / $119.49	Professional	TC	$42.78	$55.87	$119.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $41.38 / $41.38	Facility		$41.38	$41.38	$41.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $18.64	Facility	TC	$18.64	$18.64	$18.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.85 / $85.67 / $158.26	Professional		$43.85	$85.67	$158.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $28.56 / $58.83	Professional	26	$21.63	$28.56	$58.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $56.51 / $102.52	Professional	TC	$20.67	$56.51	$102.52
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $45.58 / $61.53	Professional		$42.13	$45.58	$61.53
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $31.59 / $39.43	Professional	26	$23.40	$31.59	$39.43
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.27 / $22.18 / $29.94	Professional	TC	$9.27	$22.18	$29.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.25 / $45.58 / $76.76	Professional		$35.25	$45.58	$76.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.37 / $28.08 / $43.99	Professional	26	$20.37	$28.08	$43.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $25.73 / $41.70	Professional	TC	$17.73	$25.73	$41.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $81.42 / $232.02 / $232.02	Facility		$81.42	$232.02	$232.02
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $101.79 / $101.79	Facility	26	$100.00	$101.79	$101.79
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $92.62 / $141.03 / $141.03	Facility	TC	$92.62	$141.03	$141.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $402.37 / $414.44 / $414.44	Professional		$402.37	$414.44	$414.44
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.60 / $130.60 / $163.95	Professional	26	$130.60	$130.60	$163.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $284.52 / $293.07 / $293.07	Professional	TC	$284.52	$293.07	$293.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $46.45	Professional		$32.34	$32.34	$46.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $37.74 / $56.67 / $112.02	Facility		$37.74	$56.67	$112.02
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $18.64	Facility	TC	$18.64	$18.64	$18.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.32 / $86.50 / $143.58	Professional		$48.32	$86.50	$143.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.76 / $28.32 / $57.10	Professional	26	$21.76	$28.32	$57.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.73 / $57.46 / $106.31	Professional	TC	$21.73	$57.46	$106.31
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $149.55 / $149.55 / $149.55	Professional		$149.55	$149.55	$149.55
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $70.76 / $70.76 / $70.76	Professional	26	$70.76	$70.76	$70.76
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $78.78 / $78.78 / $78.78	Professional	TC	$78.78	$78.78	$78.78
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $50.68 / $90.65	Professional		$36.86	$50.68	$90.65
United Facility/Professional Facility Modifier Low / Median / High Price $34.02 / $34.02 / $42.49	Facility		$34.02	$34.02	$42.49
United Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $61.39 / $130.87	Professional		$38.10	$61.39	$130.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $24.16 / $58.04	Professional	26	$17.19	$24.16	$58.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $37.42 / $76.76	Professional	TC	$19.05	$37.42	$76.76