Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $81.75 / $209.01	Facility		$29.01	$81.75	$209.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.91 / $4.38 / $17.88	Facility	26	$3.91	$4.38	$17.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.92 / $30.45 / $85.00	Professional		$23.92	$30.45	$85.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.86 / $4.23 / $16.72	Professional	26	$2.86	$4.23	$16.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.67 / $77.45 / $226.50	Professional	50	$69.67	$77.45	$226.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.30 / $13.01 / $58.96	Professional	52	$9.30	$13.01	$58.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $25.10 / $51.90	Professional	TC	$18.35	$25.10	$51.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.55 / $19.55 / $19.55	Professional		$19.55	$19.55	$19.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9.92 / $293.00 / $876.00	Facility		$9.92	$293.00	$876.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $42.80 / $84.95	Professional		$24.75	$42.80	$84.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.40 / $11.80 / $38.58	Professional	26	$3.40	$11.80	$38.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $29.08 / $39.22 / $61.77	Professional	50	$29.08	$39.22	$61.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.16 / $28.93 / $60.44	Professional	TC	$15.16	$28.93	$60.44
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $57.50 / $100.00 / $372.62	Facility		$57.50	$100.00	$372.62
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $47.89 / $103.16	Professional		$37.18	$47.89	$103.16
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.59 / $24.56	Professional	26	$7.41	$10.59	$24.56
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $37.06 / $91.06	Professional	TC	$28.39	$37.06	$91.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $26.10	Facility		$26.10	$26.10	$26.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $39.71 / $72.61	Professional		$22.51	$39.71	$72.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.22 / $5.48 / $14.49	Professional	26	$3.22	$5.48	$14.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.23 / $31.79 / $59.72	Professional	TC	$19.23	$31.79	$59.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $33.56 / $41.19	Professional		$30.51	$33.56	$41.19
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.28 / $3.61 / $4.43	Professional	26	$3.28	$3.61	$4.43
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.22 / $29.94 / $36.75	Professional	TC	$27.22	$29.94	$36.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.70 / $29.90 / $48.21	Professional		$22.70	$29.90	$48.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $2.88 / $3.94 / $6.17	Professional	26	$2.88	$3.94	$6.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $31.56 / $51.15	Professional	TC	$21.78	$31.56	$51.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $68.06 / $132.93 / $132.93	Facility		$68.06	$132.93	$132.93
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $21.14 / $100.00 / $100.00	Facility	26	$21.14	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $311.26 / $311.26 / $311.26	Professional		$311.26	$311.26	$311.26
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.00 / $129.00 / $129.00	Professional	26	$129.00	$129.00	$129.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $252.63 / $252.63 / $252.63	Professional	TC	$252.63	$252.63	$252.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $22.22 / $33.96 / $65.53	Facility		$22.22	$33.96	$65.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.92 / $43.46 / $67.09	Professional		$23.92	$43.46	$67.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.22 / $5.73 / $14.49	Professional	26	$3.22	$5.73	$14.49
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $32.61 / $58.00	Professional	TC	$19.76	$32.61	$58.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $73.17 / $73.17	Professional		$73.17	$73.17	$73.17
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Professional	26	$10.01	$10.01	$10.01
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $63.15 / $63.15 / $63.15	Professional	TC	$63.15	$63.15	$63.15
United Facility/Professional Facility Modifier Low / Median / High Price $26.80 / $26.80 / $26.80	Facility		$26.80	$26.80	$26.80
United Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $31.52 / $76.22	Professional		$17.89	$31.52	$76.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.61 / $4.69 / $12.85	Professional	26	$2.61	$4.69	$12.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.84 / $24.15 / $53.44	Professional	TC	$14.84	$24.15	$53.44