Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $8.85 / $53.19	Facility	26	$8.36	$8.85	$53.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.87 / $36.09 / $133.66	Professional		$29.87	$36.09	$133.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $8.88 / $32.15	Professional	26	$7.66	$8.88	$32.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $27.35 / $97.43	Professional	TC	$21.94	$27.35	$97.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $39.22 / $50.93	Professional		$39.22	$39.22	$50.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $6.42 / $6.90	Professional	26	$6.42	$6.42	$6.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $40.14 / $81.98	Professional		$30.49	$40.14	$81.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $11.96 / $23.90	Professional	26	$9.47	$11.96	$23.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $28.17 / $56.34	Professional	TC	$20.65	$28.17	$56.34
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $40.79 / $100.00	Professional		$32.47	$40.79	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $10.67 / $25.29	Professional	26	$8.38	$10.67	$25.29
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $30.05 / $71.73	Professional	TC	$23.86	$30.05	$71.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.55 / $42.69 / $95.97	Professional		$29.55	$42.69	$95.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $11.04 / $24.34	Professional	26	$7.71	$11.04	$24.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.72 / $31.80 / $78.95	Professional	TC	$21.72	$31.80	$78.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $50.69 / $68.43	Professional		$25.10	$50.69	$68.43
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $9.69 / $13.08	Professional	26	$6.53	$9.69	$13.08
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $40.99 / $55.34	Professional	TC	$18.57	$40.99	$55.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $49.84 / $83.26	Professional		$37.04	$49.84	$83.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $11.63 / $18.22	Professional	26	$8.56	$11.63	$18.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $47.48 / $76.95	Professional	TC	$32.79	$47.48	$76.95
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $293.00 / $293.00 / $326.10	Professional		$293.00	$293.00	$326.10
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.28 / $55.28 / $70.34	Professional	26	$55.28	$55.28	$70.34
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $255.75 / $283.00 / $283.00	Professional	TC	$255.75	$283.00	$283.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $33.11	Professional		$32.34	$32.34	$33.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $49.49 / $103.33	Professional		$30.49	$49.49	$103.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.77 / $10.87 / $24.00	Professional	26	$7.77	$10.87	$24.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.72 / $30.90 / $74.33	Professional	TC	$21.72	$30.90	$74.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $121.80 / $121.80 / $121.80	Professional		$121.80	$121.80	$121.80
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $29.79 / $29.79 / $29.79	Professional	26	$29.79	$29.79	$29.79
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $92.01 / $92.01	Professional	TC	$92.01	$92.01	$92.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $50.40 / $61.20	Professional		$37.65	$50.40	$61.20
United Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $37.17 / $93.24	Professional		$22.95	$37.17	$93.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.38 / $22.46	Professional	26	$6.92	$9.38	$22.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $27.79 / $69.45	Professional	TC	$16.20	$27.79	$69.45